Covid-19: U.S. Virus Cases Fall as Variants Spread

In recent days, coronavirus cases have been dropping steadily across the United States, with hospitalizations falling in concert. But health officials are growing increasingly concerned that quickly circulating variants of the virus could cause new surges of cases faster than the country is managing to distribute Covid-19 vaccines.

Public health experts likened the situation to a race between vaccination and the virus’s new variants — and the winner will determine whether the United States is approaching a turning point in its battle against the coronavirus, now entering a second year.

“We’re definitely on a downward slope, but I’m worried that the new variants will throw us a curveball in late February or March,” said Caitlin M. Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

Nationwide, new coronavirus cases have fallen 21 percent in the last two weeks, according to a New York Times database, and some experts have suggested this could mark the start of a shifting course after nearly four months of ever-worsening case totals.

This week, the University of Washington’s Institute for Health Metrics and Evaluation, which puts out a predictive model that is widely used for planning, including by some government agencies, released a projection saying new cases in the United States would decline steadily from now on.

“We’ve been saying since summer that we thought we’d see a peak in January and I think that, at the national level, we’re around the peak,” said Dr. Christopher J.L. Murray, director of the institute. Still, Dr. Murray cautioned that variants of the virus could “totally change the story.”

Health officials warned that they have little foresight into what the rest of the winter and spring will bring. President Biden’s new administration has vowed to impose speed and order to what has been a slow, bumpy rollout of vaccinations, in which some 15 million people have received at least one dose of a Covid-19 vaccine. But it is not clear how many vaccines will be available in cities across the country in the coming weeks. The public should still wear masks, officials say, avoid large gatherings and sign up to be vaccinated as soon as they are eligible.

Some experts, looking abroad at how new viral variants sent cases surging in Britain, Ireland, South Africa and northern Brazil, said the United States could merely be in a lull before a new spike begins. Even after an epidemic’s peak, it remains dangerous: Sometimes just as many people are infected after the peak as were before.

Nicolas A. Menzies, one of several scientists running the Prevention Policy Modeling Lab at Harvard’s T.H. Chan School of Public Health, which tracks levels of herd immunity, said he felt it was “more probable than not” that infections would climb again.

It is important to spot regions where variant strains are turning up, he said, since they would be the most likely to have early surges. Thus far, the variant that has been prevalent in Britain and a new variant have been found most often in Southern California and Florida, according to the Centers for Disease Control and Prevention. Cases are slowly declining in both regions. But it’s “still too early to tell,” he said.

The United States continues to average 181,000 new cases each day, more than any point of the pandemic before December. Deaths from the coronavirus also remain extraordinarily high, with more than 4,300 deaths announced on Wednesday, the second-highest daily total of the pandemic.

Another 3,730 deaths were announced across the country on Friday, and Florida became the fourth state where the death toll has surpassed 25,000.

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Cuomo Warns New York Will Temporarily Run Out of Vaccine

On Friday, Gov. Andrew M. Cuomo warned that New York State would run out of vaccine doses by the end of the day, and said providers should only schedule appointments for “allocations they know they will receive.”

We run out of allocation today, the Week 1 to 5 allocation will be exhausted by the end of the day, Friday. We may already be exhausted, frankly, midday on Friday. And we’re now going week to week on the next week’s allocation. We have 28,000 dosages left in the state, from Week 1 to 5. If you add up all the dosages that are not in arms in the state, it’s 28,000. Problem is, we administer about 80,000 dosages per day. Right, so 28,000 does not get you through the day. Providers should only schedule appointments for allocations they know they will receive. In other words, in this confusing situation, the last thing we want to do is cancel appointments. Right, so don’t schedule an appointment unless you know you have an allocation.

New York State expected to run out of its supply of coronavirus vaccines before the end of Friday, but more doses would arrive in the coming days, Gov. Andrew M. Cuomo announced at a news conference.

“We will — by the end of today fully — utilize all of the dosages that have been delivered,” Mr. Cuomo said Friday.

Ninety-seven percent of New York State’s vaccine inventory, accumulated over the past five weeks, has been administered, the governor noted, and a total of 28,000 first doses were left in inventory Friday morning. Mr. Cuomo added that the state inoculates roughly 80,000 people per day.

Vaccines have been slowly rolling out in the United States and states are dealing with shortages just as new virus variants, some more contagious, are spreading.. The C.D.C. has warned that the more transmissible variant first discovered Britain, which is thought to be 50 percent more contagious, might become the dominant source of infection in the United States by March. Although public health experts are optimistic that the existing vaccines will be effective against that variant, known as B.1.1.7, it may drive up the infection rate if enough people remain unvaccinated.

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European Union Wants Vaccinations to Be ‘Accelerated’

European Union leaders on Thursday expressed frustration over the coronavirus vaccine rollout and urged the bloc to accelerate the delivery of more vaccine doses.

“Leaders want vaccination to be accelerated, and in this respect, commitments on deliveries made by companies must be respected. Leaders reaffirmed the vaccines should be distributed at the same time, and must be on pro rata population basis. And we reaffirmed the need to have a close follow-up of the vaccination process.” “Indeed, across Europe, the health situation remains very serious. And yes, there is reason for hope because of the vaccines. But there’s also strong reason for concern with the new variants we are observing. We must therefore remain focused, and we must remain determined in our response. We must ensure delivery of vaccines from the companies. And we must ensure the quick and efficient use of the available vaccines.”

AstraZeneca informed the European Union on Friday that it would deliver fewer doses of the vaccine it created with the University of Oxford than planned, a fresh blow to the bloc’s efforts to ramp up its sluggish inoculation efforts.

The news comes a week after Pfizer abruptly notified the European Union and several countries outside of the United States that deliveries of its vaccine would be heavily disrupted until the second week of February because of upgrades being made to its facility in Puurs, Belgium, in order to ramp up output.

AstraZeneca said that it still intended to get “tens of millions of doses” to the bloc’s 27 member states in February and March, but that the deliveries would “be lower than originally anticipated due to reduced yields at a manufacturing site within our European supply chain.” AstraZeneca noted that it would eventually ramp up production but did not provide a timeline.

The European health commissioner, Stella Kyriakides, said that the European Union had “expressed deep dissatisfaction” with the company’s announcement. “We insisted on a precise delivery schedule on the basis of which Member States should be planning their vaccination programs,” she said in a tweet, adding that the bloc needed “predictability and stability of deliveries, and acceleration of the distribution of doses.”

The AstraZeneca vaccine is awaiting approval for use in the European Union. The company applied for authorization on Jan. 12, and the European Medicines Agency, the bloc’s drug regulator, has said it will likely make a decision at a meeting on Jan. 29.

The European Union has come under criticism for being slower than the United States and Britain to authorize coronavirus vaccines, and its member states are lagging behind the two countries in rolling out immunizations. Frustrated countries like Austria have pushed for faster approval of the AstraZeneca vaccine, though that would not mean delivery would be any swifter.

Fifteen people have had a severe allergic reaction, anaphylaxis, after receiving Moderna’s coronavirus vaccine, the Centers for Disease Control and Prevention reported on Friday. The reactions have been rare, occurring at a rate of 2.1 cases per million Moderna doses administered, the agency said.

So far, anaphylactic reactions to the Pfizer-BioNTech Covid vaccine appear somewhat more common: 45 have occurred, with a rate of 6.2 cases per million doses given.

The estimated rates for the two vaccines “may change as additional doses of Covid-19 vaccine are administered and C.D.C. continues to collect more information,” the agency said in a statement. It also said no deaths from the reactions had been reported.

When anaphylaxis occurs, it usually starts within minutes of the injection. Symptoms may include breathing trouble, dropping blood pressure, hives, wheezing, nausea and swelling of the tongue. The condition is life-threatening, and vaccination centers must be ready to provide immediate treatment with a shot of epinephrine and transport patients to hospitals, the agency said in a report published on Friday.

The rates are comparable to those for other vaccines, the agency said, and noted that anaphylaxis “is readily diagnosed, and effective treatments are available.”

The vaccines, combined with measures like masks and social distancing, “are one of the best tools we have to fight the pandemic,” the C.D.C. said.

The published report was based on data from Dec. 21 to Jan. 10, and included only 10 cases of anaphylaxis, out of 4,041,396 first shots of the Moderna vaccine given. But the statement issued on Friday updated the total, including five more cases.

The 10 cases in the published report all occurred in people who had previously had allergic reactions to drugs or foods, including five who had had anaphylaxis before, though not from vaccines. All 10 patients were women, ages 31 to 57, which may be partly because more women than men received the vaccine. But the report also noted that 80 percent of anaphylactic reactions to other vaccines reported to the government tracking system were in adult women.

All 10 women received epinephrine. Six were hospitalized, including five in intensive care, four of whom had to be intubated. The published report said follow-up information was available for only eight of the 10, and that those eight “were discharged home or had recovered” at the time their information was submitted.

The report also described 43 allergic reactions that occurred within 24 hours of the vaccination and were not anaphylaxis, with symptoms like rashes, itching, itchy sensations in the mouth and throat, sensations of throat closure and respiratory symptoms. Most of those reactions, 91 percent, occurred in women. Sixty percent of the reactions were considered nonserious.

The report was based on data from the government’s Vaccine Adverse Event Reporting System, which relies on health care providers and patients to submit information.

The Moderna and Pfizer-BioNTech vaccines are the only ones authorized for emergency use in the United States. They are similar, consisting of genetic material called mRNA encased in minute fatty bubbles known as lipid nanoparticles.

A year into the worst global health crisis in a century, and much of the world feels frozen in place.

Countries that had loosened up their frontiers after imposing restrictions earlier in the pandemic are now tightening them again, worried about new, more contagious variants of the coronavirus. Some are tightening travel restrictions or imposing new rules on travelers.

In the United States, President Biden signed a series of executive orders aimed at thwarting the pandemic, including a requirement that travelers coming from abroad quarantine after arriving in the United States, though it is not clear how that will be enforced.

He also signed an order requiring masks for many kind of interstate travel. Travelers will have to wear masks in airports, as well as on commercial airplanes, trains and public maritime vessels, including ferries, and on certain other modes of public transportation like intercity buses.

While the United States is merely making traveling less hospitable, countries in Europe are going further, with plans to tighten its borders.

European Union leaders agreed to limit nonessential travel within the bloc and from nonmember countries in a bid to slow the spread of two variants that are already present in multiple countries in the region.

Leaders from the bloc’s 27 nations, meeting via teleconference late Thursday, agreed to take coordinated action in response to the variants, which scientists believe originated in Britain and in South Africa and appear to be significantly more contagious than others.

Some E.U. countries have already limited access for their neighbors, a move that is generally avoided in the principally borderless bloc but has been tolerated because of the extraordinary circumstances.

After the conference call, President Emmanuel Macron’s office announced that France would make PCR tests compulsory for all travelers coming from other European Union countries, starting Sunday at midnight. The tests must be done no later than 72 hours before departure.

In Britain, which completed its exit from the bloc on Jan. 1, flights from Latin America and Portugal were banned over fears of a variant first discovered in Brazil. Flights from South Africa, where another highly contagious variant was discovered last month, are also banned.

In all, Britain itself is isolated from more than a dozen countries.

And in China, where the virus spiraled out of control during the Chinese Lunar New Year in 2020, officials are discouraging travel over the holiday, which begins Feb. 12. The new year is usually the occasion for the largest annual human migration in the world.

Beijing is restricting the number of passengers allowed on public transit and has extended the quarantine period for travelers returning from overseas. Schools have been closed, and the authorities said on Wednesday that people returning to rural areas for the holiday must test negative for the virus and quarantine at home for 14 days.

Ma Xiaowei, the National Health Commission minister, has blamed the recent outbreak on travelers returning from overseas and on workers handling imported food.

Three locally transmitted coronavirus cases were confirmed on Thursday in Shanghai, China’s largest city, the first in the city in about two months.

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Fauci Promises Coronavirus Response Based on Science

Dr. Anthony S. Fauci, President Biden’s chief medical adviser for Covid-19, addressed reporters from the White House on Thursday, and warned the nation was “still in a very serious situation” because of the pandemic.

First of all, obviously, we are still in a very serious situation. I mean, to have over 400,000 deaths is something that, you know, is unfortunately historic in the very in the very bad sense. When you look at the number of new infections that we have, it’s still at a very, very high rate. Hospitalizations are up. There are certain areas of the country, as I think you’re all familiar with, which are really stressed from the standpoint of beds, from the standpoint of the stress on the health care system. However, when you look more recently at the seven-day average of cases, remember, we were going between three and 400,000, and two and 300,000. Right now, it looks like it might actually be plateauing. One of the things that we’re going to do is to be completely transparent, open and honest. If things go wrong, not point fingers, but to correct them and to make everything we do be based on science and evidence. It was very clear that there were things that were said, be it regarding things like hydroxychloroquine hydroxychloroquine and other things like that, that really was an uncomfortable because they were not based on scientific fact. I can tell you, I take no pleasure at all in being in a situation of contradicting the president. So it was really something that you didn’t feel that you could actually say something, and there wouldn’t be any repercussions about it. The idea that you can get up here and talk about what you know, what the evidence, what the science is, and know, that’s it. Let the science speak. It is somewhat of a liberating feeling.

Dr. Anthony S. Fauci, the longtime government infectious disease expert, has returned to the White House spotlight, offering both reassurances and warnings.

Dr. Fauci, shunned by President Donald J. Trump but embraced by President Biden, appeared in the White House briefing room on Thursday to speak to reporters about the pandemic.

He did not mince words, and appeared to enjoy feeling that he no longer had to.

“Historic, in the very bad sense,” was his take on the pandemic, as total cases in the United States edged near the 25 million milestone.

He warned that the nation was “still in a very serious situation,” even if the number of cases appears to be plateauing, pointing to more infectious variants of the virus that could cause spikes in cases in the coming months.

Dr. Fauci, who is now Mr. Biden’s chief medical adviser for the pandemic, said that the vaccines now in use in the United States appeared effective against the new variants so far.

And even if variants do end up diminishing the vaccines’ effectiveness, the drugs will still provide good protection, he said, citing their considerable “cushion effect.”

If need be, he said, the vaccines can be modified.

“That is not something that is a very onerous thing,” he said. “We can do that given the platforms we have.”

The federal government and the states have stumbled, however, in vaccinating Americans on a large scale. And it is more important than ever to do so, Dr. Fauci said. The more viruses spread, the more opportunities they have to mutate.

“If you can suppress that by a very good vaccine campaign, then you could actually avoid this deleterious effect that you might get from the mutations,” he said.

If the United States can vaccinate 70 percent to 85 percent of the population by the middle or end of the summer, he predicted, “by the time we get to the fall, we will be approaching a degree of normality.”

On Thursday, speaking of the problems ahead without a president glowering over his shoulder, Dr. Fauci appeared to be enjoying his own return to normality. Asked how it felt, he paused a beat or two before delivering his review.

“It is somewhat of a liberating feeling,” he said.

An unusual experiment to prevent nursing home staff members and residents from infection with the coronavirus has succeeded, the drug maker Eli Lilly said on Thursday.

A drug containing monoclonal antibodies — laboratory-grown virus fighters — prevented symptomatic infections in residents who were exposed to the virus, even the frail older people who are most vulnerable, according to preliminary results of a study conducted in partnership with the National Institutes of Health.

The researchers found an 80 percent reduction in infections among residents who got the drug compared with those who got a placebo, and a 60 percent reduction among the staff, Eli Lilly said.

The study included 965 participants at nursing homes: 666 staff members and 299 residents. The data have not yet been peer-reviewed or published. The company expects to present the findings at a future medical meeting and to publish them in a peer-reviewed journal, but did give a timeline.

The drug, bamlanivimab, has an emergency-use authorization from the Food and Drug Administration that allows it to be provided to symptomatic patients early in the course of their infection. This study sought to establish whether the drug could stop infections before they started.

It was an unusual experiment: In trucks equipped with mobile labs, medical workers sped to nursing homes the moment a single infection was detected there. Then they set up temporary infusion centers to administer the drug.

Although the study has ended, Dr. Daniel Skovronsky, Eli Lilly’s chief scientific officer, said the company would continue to rush to nursing homes in its study network when an outbreak is detected.

“Everyone will get the drug,” he said.

The comedian Dave Chappelle has tested positive for the coronavirus and has canceled several upcoming shows at the Stubb’s Waller Creek Amphitheater in Austin, Texas, a spokeswoman told The Associated Press.

The venue’s website showed cancellations for four shows through Tuesday.

Mr. Chappelle, who had been hosting socially distanced shows in Ohio since June, with rapid testing for audience members and himself, moved his shows to Austin during the winter, the spokeswoman said.

Mr. Chappelle is asymptomatic and quarantining, she said.

Joe Rogan, a comedian and podcast host who had been scheduled to perform with Mr. Chappelle on Friday and Saturday, apologized for the cancellations. “We’ll reschedule them as soon as we can,” Mr. Rogan said early Friday in an Instagram post.

Mr. Chappelle’s positive test result came about three months after he hosted “Saturday Night Live” and commented on the pandemic in a monologue that also heavily touched on the presidential election.

“Do you guys remember what life was like before Covid?” Mr. Chappelle said. “I do. There was a mass shooting every week. Anyone remember that? Thank God for Covid. Someone had to lock these murderous whites up and keep them in the house.”

The Hungarian government has for months lauded the opportunities of Russia’s Sputnik vaccine. In November, the foreign minister made public his talks with Russian counterparts about the possibility of manufacturing the Russian vaccine in Hungary. On Thursday, the country approved the Russian vaccine and one made by AstraZeneca for use.

And on Friday, after a meeting in Moscow with his Russian counterpart, Hungary’s foreign minister said that Hungary would buy two million doses of the Russian vaccine.

The moves make Hungary the first European Union nation to move outside the bloc’s supply chain, which the country’s president, Viktor Orban, said was moving too slowly.

“What I need, and what the Hungarian people need, is not an explanation, but a vaccine,” Mr. Orban said. “And if it is not coming from Brussels, then it must come from elsewhere.”

The European Union has approved two coronavirus vaccines: one made by Moderna and one made by Pfizer and BioNTech. The bloc is expected to decide this month whether to authorize the AstraZeneca vaccine.

Each E.U. member state is allotted vaccine doses based on population size, and the bloc has ordered 2.3 billion doses of several vaccines, some of which are still in development.

But a disruption in Pfizer’s production facility in Puurs, Belgium, has stalled or stopped deliveries in Europe and elsewhere, causing frustration. The company has vowed to resume deliveries by mid-February, and says that production upgrades will enable it to increase its output.

In a radio interview on Friday morning, Mr. Orban called the E.U.’s vaccination rate “simply unacceptable.” He added, “It cannot be that Hungarian people are dying because vaccine procurement in Brussels is slow.”

Some Hungarian experts have expressed concern that the government’s approach might increase vaccine skepticism, which might thwart a national vaccination plan.

“The Hungarian authority suddenly approved these two vaccines under political pressure,” said Dr. Ferenc Falus, Hungary’s former chief medical officer, said in reference to the AstraZeneca and Sputnik vaccines. “It would have been better for them to wait for the approval of the European Union’s medicine agency. This is especially incomprehensible in the case of Astra, which will receive the European Union’s approval within days.”

The European Union drugs regulator, the European Medicines Authority, said that the developer of the Sputnik vaccine had “submitted a request for scientific advice to the agency.” That step comes well before a company is ready to submit data for the regulator’s review of its work, let alone applying for authorization to distribute a vaccine to European Union countries.

KYIV, Ukraine — After a revolution seven years ago, Ukrainians discovered that their ousted president had used public money to build himself a gigantic palace with a private zoo, a golf course and a garage full of antique cars.

To prevent repeats of such corruption, a raft of reforms were put in place, including a requirement that nearly all government contracts be made public, lest secret kickbacks slip into the pockets of high-ranking officials.

The overhaul, widely seen as a rare success in the country’s otherwise halting anticorruption drive, covered tens of millions of dollars in annual medical procurement deals.

But to secure coronavirus vaccine supplies, Ukraine has been forced to largely abandon the rule — a move that the government says is not its choice but rather a demand of the pharmaceutical giants that control the supply.

In negotiating with national governments, drug companies like Pfizer, Moderna and Johnson & Johnson have insisted that many of the deals’ terms amount to trade secrets and must therefore be kept confidential.

Health advocacy groups have criticized those arrangements, saying that governments far better positioned than Ukraine to spend vast sums on doses have been too willing to accept such secrecy.

The requirement has hamstrung the Ukrainian government and forced one state-owned procurement company that was set up to prevent graft in the medical system to be sidelined because it was legally required to disclose the terms of all contracts.

“This is due to extremely strict privacy rules and nondisclosure policies, which the procurement company will not be able to comply with under Ukrainian law,” Svitlana Shatalova, a deputy minister of health, said at a news conference on Thursday.

The nondisclosure agreements allow pharmaceutical companies to negotiate prices, delivery timelines and other conditions for vaccine deals without governments or their citizens comparing the agreements to those struck with other nations.

According to a document that a European official posted on social media in December and quickly deleted, the European Union negotiated a lower price for Pfizer’s vaccine — 12 euros, or about $14.60, per dose — than the U.S. government, which agreed to pay $19.50 per dose. European nations tend to pay substantially lower prices for drugs than the United States does.

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Long Lines as Beijing Starts Mass Coronavirus Testing

The authorities in Beijing set up temporary testing sites after a spike in coronavirus infections. Long lines formed as the city tested nearly two million people on Friday.

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Nearly two million residents of Beijing were being tested for the coronavirus on Friday as the city rushed to stem mainland China’s worst outbreak since the virus was first detected.

Health officials set up temporary testing facilities in two major districts of Beijing, China’s capital, after three locally transmitted cases were confirmed there on Thursday.

The authorities in Shanghai, China’s business capital and biggest city, were also testing hospital employees after two health care workers tested positive on Thursday. Shanghai recorded six new locally transmitted cases on Friday.

New infections were also reported on Friday in four northern provinces — Hebei, Heilongjiang, Jilin and Shanxi — and in the eastern province of Shandong. That brings the total number of new cases across China this week to at least 500.

While the active case count is still far lower than that of the United States and other countries, the outbreak threatens to undermine the government’s success in stamping out the virus and bringing life in China back to normal.

More than 28 million people have been placed under some kind of lockdown across China in recent weeks, mostly in northern areas. Officials fear that new infections could lead to another major outbreak during the Lunar New Year holiday, when hundreds of millions of people travel across the country to celebrate with their families.

Last January, the coronavirus was spread far beyond its original epicenter, the central Chinese city of Wuhan, in part by people traveling home for Lunar New Year — weeks before health officials in Beijing acknowledged the risk of human-to-human transmission.

In Beijing this month, the authorities have closed all schools, limited the number of passengers allowed on public transit and extended quarantine requirements for travelers returning from overseas to three weeks, up from two weeks.

The central authorities are also requiring anyone traveling to rural areas for Lunar New Year to first test negative for the virus and then quarantine for 14 days — a move that could discourage many people from returning to their hometowns for the seven-day holiday.

In other developments around the world:

• Bangladesh will begin a nationwide coronavirus vaccination campaign starting with a gift from India — two million vaccine doses — by next week. Bangladesh, whose population is about 163 million, will also buy 30 million additional doses from India, said Muhibur Rahman, a health ministry secretary. He said that Gavi, the Vaccine Alliance, had pledged to cover doses for 20 percent of Bangladesh’s population. The rollout plan includes “freedom fighters of Bangladesh’s war of independence in the priority list,” Mr. Rahman said, referring to the 1971 conflict with Pakistan that led to Bangladesh’s creation. The country’s health minister told reporters this week that 42,000 volunteers had been trained to carry out the inoculation drive.

• Paraguay’s health minister announced that the country had arranged to buy three million doses of coronavirus vaccines from two pharmaceutical companies and plans to start vaccinations in the second half of February, Reuters reported. The minister, Julio Mazzoleni, said the companies would be named when the contracts are signed. The country plans to purchase another 4.2 million doses through Covax, a World Health Organization program.

Despite early successes in handling the pandemic, Germany’s health authorities have now registered a total of 50,000 Covid deaths since the virus was first detected in the country nearly a year ago. And 30,000 of those deaths have occurred since Dec. 9.

“These are not just numbers. These are people who died in loneliness,” Chancellor Angela Merkel said at a news conference on Thursday. “These are families who mourn them. We have to be aware of that, too, again and again.”

Daily reported new infections in the country are decreasing amid a weekslong lockdown, with the authorities registering 17,862 new cases on Thursday, almost 4,500 fewer than a week earlier. But rising death tolls typically trail behind spikes in infection numbers.

In response to the coronavirus’s first wave, Germany locked down early and effectively. Experts attributed the country’s relatively low early fatality rate to high testing rates, well-equipped hospitals and the young age of many of the first people to become infected there.

Since mid-December, however, the daily tolls have regularly surpassed 1,000, in a country of about 83 million people.

Early this month, pictures taken inside a mortuary in Meissen, in the east of the country, showed coffins stacked three-high. And on Thursday of last week — the country’s worst pandemic day so far — 1,244 people died from Covid in 24 hours.

Mongolia’s prime minister has resigned after protests in the country’s capital, Ulaanbaatar, over the government’s pandemic response.

The country’s Parliament on Friday approved the resignation of Prime Minister Khurelsukh Ukhnaa, who will be replaced by the chief cabinet minister, the state news media reported. The deputy prime minister and health minister also submitted their resignations.

Protesters took the streets on Wednesday after a widely circulated video showed a Covid-19 patient and her newborn baby being hastily escorted from a hospital to a quarantine facility. Demonstrators were protesting the treatment of the patient, who was still wearing a nightgown and slippers when she was escorted out of the hospital. Some protesters wore nightgowns and slippers in a show of support for the woman.

The World Health Organization praised Mongolia early on in the pandemic for its quick response, with the country shutting down its borders and ceasing much of its coal mining activity. Mining makes up nearly half of its export revenue and provides some of the best-paying jobs in the country.

And although Mr. Khurelsukh won landslide elections last year, the government has faced dissatisfaction over a flailing economy and unemployment. He said in a resignation letter that he would “accept the demand of the public.”

Laura M. Holson, a Times reporter and editor, caught Covid-19 during the New York City outbreak last April, but the acute phase of the illness was just the beginning. Here, she tells her story.

I remember the second time I thought I would die.

The first time was April 17, 2020, when, after finding out I had Covid-19 nine days earlier with aches and a cough, my fever shot up to 101.8, I could barely breathe, and my family doctor told me I had bacterial pneumonia.

The second time I thought I would die was different, yet eerily the same. It was June 22, nearly three months after the initial diagnosis. By then the cough had softened, and I was well past the acute phase of Covid-19, having tested negative twice. The chest tightness had passed, supplanted by a nagging ache. I had lost eight pounds as nausea tamped my appetite, and my heart seemed to race without reason. I was so tired I sometimes fell asleep upright in my chair. And my fever persisted, too.

On that cloudless day in June, the temperature outside hovered at a pleasant 85. I was seated on the couch, working on my laptop when, at about 4 p.m., the crushing chest pain I experienced during Covid’s earliest days suddenly returned. My pulse began to quicken, and a shawl of heat gathered around my shoulders, crept up my neck and swallowed my head. I began to sweat. It felt as if the air was being squeezed out of my lungs. Breathe, I told myself. BREATHE. I stood up, gasping, and walked to the window to look outside.

Could this really be happening again?

Read her full account.

About 1,500 people from Pacific Island nations are due to be flown into the Australian state of Victoria to pick fruit on farms. And although the move will help alleviate a shortage of farm hands that has plagued the industry for months because of the coronavirus, it also underscores the greater health risks and economic effects that poorer and non-white populations have faced in the pandemic.

Victoria is one of the last states in Australia to allow Pacific Islanders in to help on farms. Nearly 200 workers from Vanuatu flew into the Northern Territory to harvest mangos in August, and other states have since followed.

Over the summer, the country has been flooded with news reports of fruit and vegetables being left to rot in fields amid a shortage of workers to pick them.

Farmers say they have had difficulty attracting locals to do the work, while some Australians counter that farmers have been unwilling to employ locals because they are “not as exploitable as a foreigner.” The sector has also been the subject of recent reports of underpaying and exploiting workers.

The supply of backpackers and foreign seasonal workers who typically make up the majority of the industry has been cut off since the country shut its borders last March in an effort to stop the spread of the virus.

Before arriving in Victoria, the Pacific Islander workers will be required to quarantine for two weeks on the Australian island state of Tasmania, Victoria’s government said on Friday. In exchange, 330 Tasmanians who have been stuck overseas will be able to return to the country and quarantine in Melbourne hotels.

Victoria has eased its pandemic restrictions after 16 consecutive days with no cases of community infection.

The party is coming to an end — or at least to a pause — in Dubai, which allowed its hotels, restaurants and clubs to continue offering live entertainment for the last half-year in the hope of sustaining its economically vital tourism industry. On Thursday, Dubai, one of the seven sheikhdoms that make up the United Arab Emirates, said that it would immediately suspend issuing new entertainment permits because coronavirus cases were mounting.

The resurgence of the virus in Dubai has forced the city to backtrack on promoting itself as one of the world’s few remaining havens for fun during the pandemic. Though it imposed a strict lockdown early on, Dubai reopened to tourists in July, and by the winter holidays, tourism had come alive again as bars and clubs filled with people escaping lockdowns in other countries.

Industry analysts reported that hotels there were 71 percent full in December, and the Emirates had begun inoculating its population with vaccines from Pfizer and Sinopharm faster than any other country except Israel. Much of the Emirates’ population is young, which may have helped hold down the country’s death toll.

But as reports of new coronavirus cases began to rise in recent weeks, Dubai’s greatest source of tourists, Britain, announced that it would start requiring anyone who returned from Dubai to quarantine. Israel, which sent thousands of tourists to Dubai after the Emirates and Israel agreed to normalize relations late last year, imposed the same restriction.

The Emirates announced 3,529 new cases on Thursday, setting a record for the 10th straight day.

Bars and restaurants in Dubai remain open, but the city’s tourism office said it would stop issuing permits for live performances and concerts in the interest of “public health and safety.” It did not say when the permits might resume.