Coronavirus UpdatesCovid-19 News: Over 150 Texas Hospital Workers Are Fired or Resign Over Vaccine Mandate

153 Texas hospital workers are fired or resign over mandatory vaccine policy.

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A demonstrator held a sign in protest at Houston Methodist Hospital in Baytown, Texas, in early June.Credit...Yi-Chin Lee/Houston Chronicle, via Associated Press

More than 150 staff members at a Houston-area hospital were fired or resigned on Tuesday for not following a policy that requires employees to be vaccinated against Covid-19.

The hospital, Houston Methodist, had told employees that they had to be vaccinated by June 7 or face suspension for two weeks. Of the nearly 200 employees who had been suspended, 153 of them were terminated by the hospital on Tuesday or had resigned, according to Gale Smith, a spokeswoman for the hospital.

Ms. Smith said employees who had complied with the vaccine policy during the suspension period were allowed to return to work a day after they became compliant.

The hospital did not specify how many workers had complied and returned to work.

Vaccine hesitancy has been high among frontline health care workers: Surveys showed that nearly half remained unvaccinated as of mid-March, despite being among the first to become eligible for the shots in December. A March 2021 survey by the Kaiser Family Foundation found that health care workers had concerns about the vaccines’ newness and their possible side effects, both of which are common reasons for waiting to be vaccinated.

Earlier this month, dozens of employees who had not been vaccinated by Houston Methodist’s deadline protested outside of the hospital against the mandatory vaccine policy.

The protest followed a now dismissed lawsuit filed last month by 117 Houston Methodist employees against their employer over the vaccine policy. The workers’ lawsuit accused the hospital of “forcing its employees to be human ‘guinea pigs’ as a condition for continued employment.”

Jennifer Bridges, a nurse who led the Houston Methodist protest, had cited the lack of full F.D.A. approval for the shots as a reason she wouldn’t get vaccinated.

U.S. District Judge Lynn N. Hughes, in the Southern District of Texas, rejected a claim by Ms. Bridges, the lead plaintiff in the lawsuit, that the vaccines available for use in the United States were experimental and dangerous.

“The hospital’s employees are not participants in a human trial,” Judge Hughes wrote. “Methodist is trying to do their business of saving lives without giving them the Covid-19 virus. It is a choice made to keep staff, patients and their families safer.”

Arthur Caplan, a professor of medical ethics at the New York University Grossman School of Medicine, said the vaccine requirement was no different than other mandates for health care workers, like getting an annual flu shot, keeping up with immunizations and wearing hairnets.

He noted that some health care workers have been fired in the past for refusing to get flu shots and said that states like New York require it.

“Health care workers have three special ethical responsibilities,” Dr. Caplan said. “One is protect the vulnerable, people who are really at risk of a disease. Secondly, put patient interests for first. It doesn’t say, ‘put your choice first.’ Third, they’re supposed to do no harm.”

Dr. Caplan also condemned a comparison by the lead plaintiff in the Houston case, Ms. Bridges, between hospital workers and Nazi concentration camp prisoners.

He suggested that the hospital employees who refused to get vaccinated would be better off in a different line of work.

“It’s like you’re in the wrong job there, buddy,” he said.

Coronavirus cases spike in Africa. ‘The India example is not lost to us.’

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Awaiting laboratory results at the Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, Kenya.Credit...Brian Otieno for The New York Times

With medical supplies depleted, vaccines scarce, doctors lamenting physical and mental fatigue and hospitals turning away patients for lack of beds or oxygen, health officials say they fear a wave like the one that ripped through India in April and May could be looming in western Kenya and other parts of Africa.

All of Africa is vulnerable, as the latest wave of the pandemic sweeps the continent, driven in part by more transmissible variants. Fewer than 1 percent of Africa’s people have been even partly vaccinated, by far the lowest rate for any continent.

“I think the greatest risk in Africa is to look at what happened in Italy earlier on and what happened in India and start thinking we are safe — to say it’s very far away from us and that we may not go the same way,” said Dr. Mark Nanyingi, an infectious disease epidemiologist at the University of Liverpool in Britain. He called a surge now gripping western Kenya a “storm on the horizon.”

Covid-related deaths in Africa climbed by nearly 15 percent last week compared to the previous one, based on available data from almost 40 nations, the World Health Organization said. But experts say the true scale of the pandemic far exceeds reported figures in Africa, where testing and tracing remain a challenge for many countries, and many nations do not collect mortality data.

In late May, before Kenya’s president and other leaders arrived to celebrate a major public holiday, health officials in Kisumu on Lake Victoria saw disaster brewing. Coronavirus cases were spiking, hospital isolation units were filling up and the highly contagious Delta variant had been found in Kenya for the first time — in Kisumu County.

Local health officials pleaded with the politicians to hold a virtual event instead, but their objections were waved away. In the weeks since, all reports show an alarming surge in infections and deaths in the county of just over 1.1 million people, with the virus sickening mostly young people.

“The India example is not lost to us,” Dr. Nyunya said.

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Here’s what to know about the Delta variant in the U.S.

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Medical personnel remove the body of a Covid-19 victim from the coronavirus ward at the Honorio Delgado Hospital in Arequipa, Peru, last week, following an outbreak of cases of the Delta strain in the city.Credit...Diego Ramos/Agence France-Presse — Getty Images

The super-contagious Delta variant of the coronavirus is now responsible for about one in every five Covid-19 cases in the United States, and its prevalence has doubled in the last two weeks, health officials said on Tuesday.

First identified in India, Delta is one of several “variants of concern,” as designated by the Centers for Disease Control and Prevention and the World Health Organization. It has spread rapidly through India and Britain.

Its appearance in the United States is not surprising. And with vaccinations ticking up and Covid-19 case numbers falling, it’s unclear how much of a problem Delta will cause here. Still, its swift rise has prompted concerns that it might jeopardize the nation’s progress in beating back the pandemic.

“The Delta variant is currently the greatest threat in the U.S. to our attempt to eliminate Covid-19,” Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said at the briefing. The good news, he said, is that the vaccines authorized in the United States work against the variant. “We have the tools,” he said. “So let’s use them, and crush the outbreak.”

The White House publicly acknowledges the U.S. is likely to miss Biden’s July 4 vaccination goal.

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Santiago Gonzalez, right, 18, with his mother, after receiving a coronavirus vaccine in Miami in May.Credit...Saul Martinez for The New York Times

The White House on Tuesday publicly acknowledged that President Biden does not expect to meet his goal of having 70 percent of adults at least partially vaccinated by July 4 and will reach that milestone only for those aged 27 and older.

It would be the first time that Mr. Biden has failed to meet a vaccination goal he has set. If the rate of adult vaccinations continues on the current seven-day average, the country will come in just shy of Mr. Biden’s target, with about 67 percent of adults partly vaccinated by July 4, according to a New York Times analysis.

White House officials have argued that falling short by a few percentage points is not significant, given all the progress the nation has made against Covid-19. “We have built an unparalleled, first-of-its-kind, nationwide vaccination program,” Jeffrey D. Zients, the White House pandemic response coordinator, said at a news briefing. “This is a remarkable achievement.”

New reported doses administered

Source: Centers for Disease Control and Prevention | Note: Line shows a seven-day average. The C.D.C., in collaboration with the states, sometimes revises data or reports a single-day large increase in vaccinations from previous dates, which can cause an irregular pattern.

In announcing the goal on May 4, Mr. Biden made a personal plea to the unvaccinated, saying getting a shot was a “life and death” choice. According to the latest figures from the Centers for Disease Control and Prevention, 150 million Americans have been fully vaccinated and 177 million have received at least one dose.

Young adults aged 18 to 26 have so far proven particularly hard to persuade. Younger Americans are less likely to be vaccinated than their elders, and factors like income and education may affect vaccine hesitancy, according to two new studies by the C.D.C.

Mr. Zients and Dr. Anthony S. Fauci, the nation’s top infectious disease expert, both stressed that the administration’s efforts would continue long after that benchmark is reached.

But health experts warn that the falloff in the vaccination rate could mean renewed coronavirus outbreaks this winter when cold weather drives people indoors, with high daily death rates in areas where comparatively few people have protected themselves with shots.

In recent weeks, new cases, hospitalizations and deaths related to the virus have declined sharply nationwide. As of Monday, the seven-day average of new virus cases across the United States was 11,243 cases a day, a nearly 30 percent decrease over the last two weeks, according to a Times database.

Lazaro Gamio contributed reporting.

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Some countries that relied on vaccines from China still face surging infections.

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Young women walking on Peace Avenue in Ulaanbaatar, Mongolia, in May.Credit...Khasar Sandag for The New York Times

Mongolia promised its people a “Covid-free summer.” Bahrain said there would be a “return to normal life.” The tiny island nation of the Seychelles aimed to jump-start its economy.

All three put their faith, at least in part, in easily accessible Chinese-made vaccines, which would allow them to roll out ambitious inoculation programs at a time when much of the world was going without.

But instead of freedom from the coronavirus, all three countries are now battling a surge in cases.

China kicked off its vaccine diplomacy campaign last year by pledging to provide a shot that would be safe and effective at preventing severe cases of Covid-19. Less certain at the time was how successful it and other vaccines would be at curbing transmission.

Now, examples from several countries suggest that the Chinese vaccines may not be very effective at preventing the spread of the virus, particularly the new variants. The experiences of those countries lay bare a harsh reality facing a post-pandemic world: The degree of recovery may depend on which vaccines governments give to their people.

Morgan Stanley says no vaccine, no entry.

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A view of the offices of the financial trading company Morgan Stanley in New York City.Credit...Justin Lane/EPA, via Shutterstock

Morgan Stanley will require employees and visitors to be vaccinated against the coronavirus when they enter its New York offices next month.

Starting July 12, employees, contingent workers, clients and visitors at Morgan Stanley’s buildings in New York City and Westchester County must attest that they are fully vaccinated, a person familiar with the matter said, citing a memo from Mandell Crawley, the bank’s chief human resources officer. Staff members who don’t will be required to work remotely, added the person, who spoke on condition of anonymity to discuss personnel-related matters.

Although the requirement relies on an honor system for now rather than proof of vaccination, it will allow the bank to lift other pandemic protocols, such as face coverings and physical distancing. Some office spaces for Morgan Stanley’s institutional securities, investment and wealth management divisions already allow only those who have received their shots to work from their desks.

Companies across America are grappling with the question of whether to ask employees about their vaccination status, or to require those returning to offices to be vaccinated. The Equal Employment Opportunity Commission said last month that both actions were legal. Still, some senior executives have worried about pushback from employees.

This month, Goldman Sachs said its employees in the United States would have to report their vaccination status. Other big Wall Street banks, including JPMorgan Chase and Bank of America, are encouraging workers to disclose their vaccination status voluntarily. BlackRock, the asset manager, will allow only vaccinated staff to return to the office beginning next month, Bloomberg reported. Those firms, however, stopped short of also asking clients and visitors to attest to being vaccinated.

The Financial Times reported earlier on Morgan Stanley’s vaccine requirements.

Lauren Hirsch contributed reporting.

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In the Philippines, Rodrigo Duterte threatens to jail those who refuse shots.

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A vaccination point in Manila on Tuesday. The Philippines is struggling to tamp down one of Southeast Asia’s worst Covid-19 outbreaks.Credit...Mark R Cristino/EPA, via Shutterstock

President Rodrigo Duterte of the Philippines has threatened to send anyone who refuses a coronavirus vaccine to jail, as the country grapples with one of the worst outbreaks in Asia.

“There is a crisis being faced in this country. There is a national emergency,” Mr. Duterte said during a weekly television program late Monday, which included an expletive-laced rant against those who chose not to get a vaccine.

“If you do not want to get vaccinated, I will have you arrested,” Mr. Duterte added. “Don’t force my hand into it, and use a strong-arm method. Nobody wants that.”

He continued on to urge anyone who did not want to be vaccinated to “leave the Philippines,” and go elsewhere, like India or America.

Mr. Duterte, a strongman leader who has long used thuggery, threats and calls for violence as part of his political persona, said he was “exasperated” by citizens who chose not to heed the government on vaccination, before ordering all local officials to look for those refusing to be immunized.

Edre Olalia, president of the National Union of Peoples’ Lawyers, said that jail time for those refusing shots would be illegal.

“There is no law that specifically empowers the president to order such arrests for said reasons, even if this is a health emergency,” Mr. Olalia said.

Mr. Duterte’s spokesman, Harry Roque, a former rights lawyer, said on Tuesday that in Philippine jurisprudence, a president can compel compulsory vaccination. But he said that this should be supported by legislation.

The Philippines is struggling to tamp down one of Southeast Asia’s worst Covid-19 outbreaks, with the government on Monday reporting 5,249 new cases, bringing the total number of cases in the country to 1.3 million.

The authorities have been trying to acquire more vaccines and have secured a supply contract for 40 million shots from Pfizer-BioNTech. The country has some 12.7 million doses, most of them from Sinovac of China.

But the Philippine vaccination program has been hobbled by distribution bottlenecks, as well as public fears. In 2017, the government halted a dengue immunization program after shots developed by the French drug firm Sanofi were linked to a severe form of the disease.

More than 830,000 school children had received the shot and dozens of deaths were reported by the time it was halted.

Cuba reports a high success rate for its homegrown Abdala vaccine.

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Cuban officials began using two locally developed vaccines in May, before Phase 3 trials were complete. A man received a dose in Havana last Thursday.Credit...Alexandre Meneghini/Reuters

Cuba began its Covid-19 mass vaccination campaign more than a month ago with homegrown, unproven vaccines, wagering that they would prove effective enough to blunt the rapid spread of the coronavirus on the cash-strapped Caribbean island.

The gamble appears to be paying off.

The Cuban health authorities said on Monday that their country’s three-shot Abdala vaccine had proved about 92 percent effective against the coronavirus in late-stage clinical trials.

Throughout the pandemic, Cuba has declined to import foreign vaccines while striving to develop its own, the smallest country in the world to do so.

The announcement places Abdala among the most effective Covid vaccines in the world, according to data from clinical trials, on a par with Pfizer-BioNTech’s 95 percent rate, Moderna’s 94.1 percent, and Russia’s Sputnik V at 91.6 percent.

On Saturday, Cuba’s state-run biotech corporation, BioCubaFarma, said that another of its vaccines, Sovereign 2, had 62 percent efficacy after two of its three required doses. Results for the full three doses are expected in the next few weeks.

The vaccine news was seen as a rare cause for celebration on an island that has been hammered both by the pandemic, which has devastated its tourism industry, and by Trump-era economic sanctions that have not been eased by the Biden administration.

Cuba is currently experiencing its worst coronavirus outbreak since the start of the pandemic. It reported 1,561 new cases on Monday, a record.

In May the health authorities began a mass vaccination campaign in Havana before the completion of Phase 3 trials, which assess a vaccine’s effectiveness and safety. The emergency step was intended to help combat the Beta variant, first detected in South Africa, which was spreading rapidly in the Cuban capital. Close to one million Cubans — about 9 percent of the national population — have now received all three doses of either Abdala or Sovereign 2, according to official figures. Officials say they are seeing a slowing of the virus’s spread in Havana, where vaccinations have been concentrated so far.

Countries including Mexico, Argentina, Vietnam and Iran have expressed interest in Cuba’s coronavirus vaccines. The high announced rate of efficacy could reinforce hopes that biotechnology exports will help lift Cuba from the depths of its economic crisis.

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With eight million shots in a day, India tries to energize its vaccination effort.

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Receiving a Covid shot during a door-to-door vaccination and testing drive in West Bengal State, India, on Monday.Credit...Rupak De Chowdhuri/Reuters

India administered 8.6 million doses of Covid vaccines on Monday, setting a national record on the first day of a new policy that offers free vaccines for all adults and aims to energize a lackluster inoculation effort.

Despite a slow start characterized by supply shortages and bickering between the states and central government, officials say that vaccine production and procurement are being accelerated to ensure that all of India’s roughly 950 million adults are fully vaccinated by the end of the year.

Monday’s total was the most Covid shots given in a single day in any country besides China, and the surge may have been partly because the vaccines were widely available and free for the first time to those younger than 45.

Local news reports have also suggested that Monday’s record may have been made possible by holding back vaccines in some states run by the governing party of Prime Minister Narendra Modi. In one state, Madhya Pradesh, the number of administered doses had shrunk to just 692 a day before the start of the new policy on Monday, when 1.6 million doses were suddenly administered.

And the boost was probably temporary — available supplies suggest that it would be difficult to sustain such a pace over the coming weeks. India has increased the availability of doses to 120 million this month, from about 75 million in May. About 135 million doses are expected to be available in July.

The inoculation drive relies almost entirely on two vaccines manufactured in India, and government officials have said that the companies behind those vaccines, the Serum Institute of India and Bharat Biotech, have promised to deliver a total of about 1.3 billion doses from August to the end of the year. The remaining doses are expected to come from other vaccines still under assessment or trial.

In India, a nation of about 1.4 billion people, the task ahead remains enormous. Although the country has administered nearly 290 million doses of vaccines so far, according to government data, less than 5 percent of the population is fully vaccinated. Less than 20 percent of people have received at least one dose.

The government has worked to iron out supply issues and ease online registration requirements that have hampered vaccine access, especially in parts of the country where smartphone and internet availability are spotty. Still, vaccine hesitancy — born of local superstitions, as well as misinformation spread by some political and religious leaders — could be another hurdle for India before it meets its ambitious goal of inoculating all adults by the end of the year.

The effort to ramp up vaccinations comes as the worst of India’s devastating second wave appears to be over, with most of India’s major cities easing restrictions and reopening the economy. India reported about 42,000 new cases on Monday, down from a peak of more than 400,000 in early May. The weekly test positivity rate has remained below 5 percent for two consecutive weeks, a sign that undetected cases in the population are also decreasing.

At least 390,000 people have died of Covid in India, according to official figures, although experts believe that is a significant undercount.

Thailand opens a holiday island to vaccinated tourists.

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Local residents at a beach on the island of Phuket, Thailand, in April.Credit...Jorge Silva/Reuters

Dreaming of golden beaches and the caress of tropical breezes? Then consider a holiday on the island of Phuket.

That’s the pitch being made by the government of Thailand, which has seen its tourism-dependent economy battered by the pandemic. On Tuesday, the Thai cabinet approved a plan, called Phuket Sandbox, that will allow vaccinated international visitors to roam the island without having to quarantine for 14 days, as is the current policy for arrivals in Thailand.

“I’m very excited that it’s finally happening,” said Nanthasiri Ronnasiri, the head of the Phuket branch of the Thai tourism authority. “Business here has been devastated. With this reopening, at least the people are being given the chance to welcome tourists again.”

But Phuket Sandbox — which is scheduled to start on July 1 with five flights from Singapore, Qatar, Israel and the United Arab Emirates — may not deliver the economic boost that its supporters were hoping for. And the late date of formal approval, with many international travelers having already made summer plans, makes it unlikely that crowds of sun seekers will be descending on the island anytime soon.

The plan allows for tourists fully inoculated with World Health Organization-approved vaccines to spend 14 days on Phuket without having to be confined to a hotel room. After two weeks and multiple Covid-19 tests, the tourists, who must be from countries considered at low or medium risk for the coronavirus, will be allowed to travel to the rest of Thailand.

While in Phuket, they will be able to swim and snorkel, drink beer and enjoy an invigorating Thai massage, all with hardly any restrictions. (Masks are still mandatory in public, however.)

Health officials have warned that Phuket Sandbox could be suspended if coronavirus infections on the island rise beyond 90 cases per week. Thailand is currently suffering from its worst outbreak since the pandemic began, and a mass vaccine rollout is far behind schedule. Only about 3 percent of the country’s 70 million people have been fully vaccinated, despite government promises to administer 100 million doses by the end of the year.

To prepare for Phuket’s reopening, the Thai government began funneling vaccines to the island this year. Even so, less than 45 percent of people in Phuket have been fully vaccinated, according to health officials. And many were inoculated with the Sinovac vaccine, which may not be as effective against variants as other shots.

Some Thai doctors argue that the country shouldn’t open up so quickly, even for a pilot project on a sequestered island.

“There is still a risk when you welcome them without quarantining that they carry the virus into the country, especially when it is the variant of concern,” said Thira Woratanarat, a public health expert at Chulalongkorn University in Bangkok. “There will be a chance that it will spread in the community.”

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The Euro 2020 soccer tournament will be decided in London after all.

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The Czech Republic and England’s players line up before the Euro 2020 match at Wembley Stadium in London today. The stadium capacity will be raised to 75 percent for the final matches.Credit...Pool photo by Matt Dunham

The semifinal and final matches of this summer’s European soccer championship will be played as scheduled at Wembley Stadium in London, tournament organizers said Tuesday, ending speculation that Britain’s pandemic travel restrictions would prompt a relocation.

European soccer’s governing body, UEFA, reached a deal with the British government after days of intense talks over UEFA’s request for exemptions that would allow thousands of overseas supporters — and as many as 2,500 V.I.P.s — to attend the matches.

The statement announcing the agreement did not specify which exemptions had been granted. But it said that the stadium’s attendance ceiling would be raised to 75 percent of capacity for the matches — the biggest crowds to attend a sporting event in Britain since the start of the pandemic.

Officials briefed on the statement said the British government had broadly agreed to let in the V.I.P.s — including commercial and broadcast partners and soccer dignitaries — but would probably admit only a small number of supporters from nations involved in the matches.

A recent surge in coronavirus cases in Britain has forced the government to back away from plans to lift its remaining social-distancing restrictions this week. Several members of the Scotland and England teams who played a game at Wembley last week are now in isolation after testing positive.

The virus is ravaging Colombia, where the death toll surpassed 100,000.

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Relatives spreading the ashes of family members who died from Covid-19, at the nature reserve of Páramo de Guerrero in Cogua municipality, Colombia, on Monday.Credit...Raul Arboleda/Agence France-Presse — Getty Images

Colombia, where a surging coronavirus and a dearth of vaccines have led to widespread protests, has surpassed 100,000 recorded Covid-19 deaths, just the 10th country to pass that milestone.

Colombia and the wider Latin American region have become emblematic of the global divide between richer nations like the United States, Britain and Israel, which have reliable access to Covid vaccines, and poorer ones that lack them and are left grappling with rising death tolls.

The crisis has been particularly acute in South America, now home to seven of the 10 countries with the highest average daily death toll per person, according to a New York Times database. The list also includes Argentina, Brazil, Paraguay, Peru, Suriname and Uruguay. On Sunday, the Covid-19 death toll in Brazil surpassed 500,000, putting it behind only the United States and India in the total number of deaths.

The situation in South America is in sharp contrast with wealthier countries, where government officials have lifted emergency orders that require people to wear masks and practice social distancing.

Colombia has been averaging more than 500 deaths per day since the spring, according to the Colombian Ministry of Health. On Monday, Colombia reported 648 deaths, another record.

Less than 10 percent of Colombia’s population of about 51 million is fully vaccinated, public health data showed.

Colombia’s surge has steadily been worsening for months.

In the spring, Claudia López, the mayor of Colombia’s capital, Bogotá, warned residents that they should brace for the “worst two weeks” of their lives.

The crisis has exacerbated public anger in Colombia, with demonstrations over a pandemic-related tax overhaul intensifying as the nation grapples with rising infections and deaths.

There has also been an uptick in abuses by the national police force, with officers beating, detaining and killing protesters, sometimes opening fire on peaceful demonstrations and shooting tear gas canisters from armored vehicles, according to interviews by The New York Times with witnesses and family members of the dead and injured.

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Coronavirus disruptions have worsened famine risk for millions, U.N.’s anti-hunger agency says.

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People displaced by conflict waited to receive donated food in March in the town of Shire in the Tigray region of Ethiopia.Credit...Baz Ratner/Reuters

Tens of millions of people in 43 countries could soon face famine, partly because of soaring food prices compounded by the coronavirus pandemic, the United Nations World Food Program said on Tuesday.

The potential famines are one example of how economic inequality worsens the pandemic’s devastation. The disparities between wealthy and developing countries have become more glaring as countries like the United States and Britain secured ample vaccine supplies while poorer countries in parts of Africa, Asia and South America struggled to get doses.

Many developing nations have long faced challenges to food security, like conflict and climate change. The pandemic complicated their problems by snarling supply chains and stalling agricultural production, driving up the cost of food.

Recent assessments indicate that 584,000 people in Ethiopia, Madagascar, South Sudan and Yemen are already suffering famine, the World Food Program said in a statement. Without urgent funding and humanitarian aid, the agency said, tens of millions more could soon join them.

“Forty-one million people are literally knocking on famine’s door,” David Beasley, the World Food Program’s executive director, told a board meeting on Monday, the statement said.

Experts have long pointed to a pandemic of hunger alongside the coronavirus, a concern Mr. Beasley raised in remarks before the United Nations Security Council in April 2020.

“We are not only facing a global health pandemic, but also a global humanitarian catastrophe,” Mr. Beasley said. “Millions of civilians living in conflict-scarred nations, including many women and children, face being pushed to the brink of starvation, with the specter of famine a very real and dangerous possibility.”

After the World Food Program won the Nobel Peace Prize last year for its efforts to combat global hunger, Mr. Beasley said that the world would be “facing famines of biblical proportions if we don’t act.”

The 41 million people who are now at risk represent an increase of about 50 percent from 2019, the World Food Program said. Mr. Beasley estimated that it would take about $6 billion to stave off disaster for them.

“We need funding, and we need it now,” he said.

C.D.C. researchers identify 1,200 cases of post-vaccination heart problems, noting they remain very rare.

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A teenager receiving a Covid-19 vaccine in Philadelphia last month. Currently, the C.D.C. strongly recommends the shots for Americans ages 12 and older. Credit...Hannah Beier/Reuters

The coronavirus vaccines made by Pfizer-BioNTech and Moderna may have caused heart problems in more than 1,200 Americans, including about 500 who were younger than age 30, according to data reported on Wednesday by researchers at the Centers for Disease Control and Prevention.

Still, the benefits of immunization greatly outweigh the risks, advisers to the C.D.C. said. They strongly recommended vaccination for all Americans 12 and older.

The heart problems are myocarditis, inflammation of the heart muscle; and pericarditis, inflammation of the lining around the heart. The risk is higher after the second dose of an mRNA vaccine than the first, and much higher in men than in women. Researchers do not know why.

But the side effect is very uncommon, just 12.6 cases per million second doses administered.

C.D.C. researchers estimated that every million second doses given to boys ages 12 to 17 might cause a maximum of 70 myocarditis cases, but would prevent 5,700 infections, 215 hospitalizations and two deaths.

Agency researchers presented the data to members of the Advisory Committee on Immunization Practices, which makes recommendations on vaccine use in the United States. (The scientists grouped together pericarditis and myocarditis for reporting purposes.)

Most cases were mild, with symptoms like fatigue, chest pain and disturbances in heart rhythm that quickly cleared up, the researchers reported. Of the 484 cases reported in Americans under age 30, the C.D.C. has definitively linked 323 cases to vaccination. The rest remain under investigation.

“These events are really very rare, extremely rare,” said Dr. Brian Feingold, an expert on heart inflammation in children at the UPMC Children’s Hospital of Pittsburgh. “That needs to be taken in context with illness and morbidity and mortality related to Covid.”

Separately, more than a dozen federal and professional medical organizations said in a joint statement on Wednesday that myocarditis “is an extremely rare side effect, and only an exceedingly small number of people will experience it after vaccination.”

The C.D.C. advisers met as the Biden administration publicly acknowledged that it expected to fall short of its goal of getting 70 percent of Americans partly vaccinated by July 4. The shortfall, officials said on Tuesday, resulted in part from reluctance among younger Americans to be immunized.

It’s unclear what causes myocarditis, or why it is more common in young men than in women. The first cases linked to coronavirus vaccines were reported in Israel, mostly among young men aged 16 to 19 years. Israel recorded 148 cases between December and May, 95 percent of them mild.

In the United States, too, myocarditis has been more common in men and boys: Up to 80 percent of cases after the second dose were in males. There has also been a clear age difference, with the side effect clustered in individuals in their late teens and early 20s.

The vast majority of patients with myocarditis recovery fully, noted Dr. James de Lemos, a cardiologist at the University of Texas Southwestern Medical Center in Dallas, who reported one of the first cases in January.

Covid-19 itself may cause heart problems in young people. A large study of collegiate athletes showed that 2.3 percent of those who had recovered from Covid-19 had heart abnormalities consistent with myocarditis.

“It’s going to be many-fold more common to get heart muscle inflammation from getting Covid than you would from getting a vaccine, even in young men,” Dr. de Lemos said.

Vaccination is becoming an even more urgent priority, given more contagious variants of the coronavirus now circulating in the United States, Dr. Paul Offit, a pediatrician at the Children’s Hospital of Philadelphia and a member of the Food and Drug Administration’s vaccine safety committee, said in an interview.

“We are not close to being near where we need to be” in terms of the percentage of the population that should be vaccinated, Dr. Offit said. “And you’re going to head into winter when you’re going to have a generally under vaccinated population.”

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The pandemic affected mental health and college plans for U.S. high schoolers.

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Brighton High School seniors during their graduation ceremony at Fenway Park in Boston last week.Credit...Brian Snyder/Reuters

Nearly 80 percent of American high school juniors and seniors say the coronavirus pandemic has affected their plans after graduation, and 72 percent of 13- to 19-year-olds have struggled with their mental health, a new survey shows.

The survey, conducted by America’s Promise Alliance, a nonprofit group, found that 58 percent of teenagers reported learning entirely or mostly online in the 2020-21 school year, and 22 percent said that they had learned about half online and half in person. Nineteen percent said they had learned mostly through in-person instruction.

The results are from a nationally representative survey of 2,400 high school students conducted in March and April.

Among those who said the pandemic had affected their plans after high school, one-third said they would attend college closer to home; one-quarter said they would attend a two-year college instead of a four-year institution; 17 percent said they would attend college remotely rather than in person; and 16 percent said they would put off attending college. Seven percent said they were no longer planning to attend college.

Nearly half the respondents who changed their plans said they were doing so because of financial pressure, suggesting that the pandemic will probably widen educational inequalities among young adults.

Given the extraordinary swell of racial-justice activism over the past year, the survey also asked students about how their schools had handled race issues. Two-thirds reported that “the history of racism” had been taught at their schools. But Asian, Black, Latino and multiracial students were less likely than white students to say that the curriculum represented their own “racial and ethnic background.”

British music festivals, a summer tradition, are in doubt for a second year.

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Festivalgoers at the Download Festival in Donington Park, England, last Friday. The three-day festival is a test event to examine how Covid-19 transmission takes place in crowds, with reduced capacity.Credit...Joe Giddens/Press Association, via Associated Press

CASTLE DONINGTON, England — At 5 p.m. on Friday, a metal band called Death Blooms walked onstage in a field in Derbyshire, England, and launched into a pummeling track to open Download Festival, Britain’s first large-scale music festival to take place since the pandemic began.

A second later, several hundred rain-soaked fans — including two men dressed as bananas — began careering into one another in front of the stage at Donington Park, arms and legs flailing, smiling ecstatically as they formed the first legal mosh pit in the country in 15 months.

Since the 1970s, music festivals have been a key part of the British summer: events where teenagers get a first taste of parent-free vacations, music fans find community and people generally get very muddy and carefree. But there is widespread concern that few events will go ahead this year despite nearly half of Britain’s population having been fully vaccinated against Covid-19. And organizers say they risk going bankrupt.

Several major festivals were canceled for the second year in a row after Prime Minister Boris Johnson said last week that social-distancing measures would continue in England until at least July 19.

Download, too, was initially canceled in March. Last weekend’s hastily arranged special edition was able to go ahead only because it was part of a government trial to see whether and how cultural life could return safely. Previous pilot events — two 3,000-person club nights and a 5,000-capacity rock concert in Liverpool — led to eight cases of potential coronavirus transmission, according to one of the scientists involved, Iain Buchan.

Download 2021 had a significantly reduced capacity of only 10,000 fans, and the lineup featured only British acts to avoid the risks of international travel and quarantines.

Attendees had to take a coronavirus test before going in, and agree to another one five days after the festival. But once inside in the grounds, masks weren’t required — though head banging, moshing and drunken conversations at the campsite were prevalent.

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Louisiana, lagging in vaccinations, gambles on a lottery.

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Gov. John Bel Edwards of Louisiana and his wife, Donna Edwards, at a news conference last week announcing cash prizes and scholarships to encourage vaccination.Credit...Hilary Scheinuk/The Advocate, via Associated Press

Like many states in the South, Louisiana’s vaccination rate has lagged significantly behind the national average, particularly among older adults, a trend that has troubled public health officials.

Some 22 percent of adults 65 and older still have not been vaccinated, compared with 12 percent nationally, according to a New York Times database. Just 34 percent of the state’s population has been fully vaccinated, compared with 46 percent nationally.

Louisiana is one of the latest states to resort to dangling financial incentives to get more shots into arms, a strategy that has kindled a broader debate over the effectiveness and wisdom of monetary enticements. It is holding a lottery, which will be paid for with federal coronavirus relief funds.

At the lottery’s unveiling last week, a jazz band played the state song, “You Are My Sunshine,” and Louisiana’s governor, John Bel Edwards, revealed a giant check for $1 million.

Mr. Edwards said amid the festivities that the money would go to a Louisiana adult who had received at least one dose of a Covid-19 vaccine. He said that the state would give away a total of $2.3 million in cash prizes and scholarships over a month. Registration for the lottery — marketed as “Shot at a Million” — began this week.

“Before launching our own program, we wanted to see how well it worked in other states, and, quite frankly, we’ve been impressed by the success that they’ve had,” Mr. Edwards said in announcing the lottery.

Louisiana’s vaccination rate, as a share of its population, is lower than every state but Mississippi. Six of the bottom eight states are in the South: They include Alabama, Arkansas, Georgia and Tennessee.

The Biden administration has made a concerted push to overcome vaccine hesitancy, particularly in the South. This week, the first lady, Jill Biden, visited Tennessee and Mississippi to encourage people to get vaccinated, while President Biden visited a mobile vaccination site in North Carolina on Thursday.

Gov. Mike DeWine of Ohio announced in May that five people would each win $1 million; the last winners were announced on Wednesday. On Thursday, Mr. DeWine said the state would focus on smaller incentives, like $25 DoorDash gift cards at select locations, and on expanding outreach and access to shots.

“We want our people to be protected,” Mr. Edwards said. “This is the way that we accomplish that. It is the way we can make sure that we return to normalcy and are able to safely gather.”

Dr. A. Mark Fendrick, the director of the University of Michigan Center for Value-Based Insurance Design, said in an interview that there was a compelling case for conducting lotteries but that they should be open only to people who were fully vaccinated.

“The people that we need to reach to get vaccinated, independent of their political affiliation, have been shown to be those populations who are likely to buy lottery tickets,” he said.

Dr. Fendrick, a primary-care physician who has studied consumer incentives for health care behavior for three decades, said it was too early to determine the effectiveness of the lotteries. In some states, he said, the lotteries coincided with making the vaccine available to teenagers, which could skew the numbers. He suggested comparing the vaccination rates in states with lotteries to those without them.

“I really want to see Michigan versus Ohio,” he said.

On Wednesday, North Carolina held its first lottery drawing as part of a similar vaccination push. Every other week, it will give away $1 million and a $125,000 scholarship to an adult and a teenager who get the vaccine.

Similar initiatives have been promoted by California, Illinois, Maryland, New Mexico and Washington.

In Oregon, however, the pace of vaccinations slipped since May, when Gov. Kate Brown announced a $1 million giveaway, The Oregonian reported this month.

Charles Boyle, a spokesman for Ms. Brown, said in an email on Tuesday night that the drop-off in vaccinations was to be expected as more residents had the shot. Oregon, he said, needed to inoculate less than 42,000 people to reach its target of at least 70 percent of adults having received at least one shot.

Mr. Boyle said that the “Take Your Shot, Oregon” campaign was part of a broader strategy that included using more and smaller vaccine clinics to lift the vaccination rate.

“No individual strategy is expected to have a singularly massive impact or to wholly reverse vaccination rate trends,” he said. “Each strategy adds a little energy to the overall effort.”

Daniel E. Slotnik contributed reporting.

A correction was made on 
June 25, 2021

Because of an editing error, an earlier version of this article misstated the date of North Carolina's first vaccination lottery drawing. It was June 23, not June 30.

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The inquiry into Emergent and its troubled Maryland vaccine plant is expanded.

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Representative James Clyburn, Democrat of South Carolina, speaking during a hearing about Emergent in Washington in May.Credit...Pool photo by Susan Walsh

Congressional investigators are expanding their inquiry of Emergent BioSolutions, the operator of a troubled Maryland vaccine-making plant, to encompass the firm’s relationship with the two companies that hired it to produce their shots.

In letters dated Tuesday, two House panels asked the companies, AstraZeneca and Johnson & Johnson, to document their efforts to supervise production of their vaccines at Emergent’s factory and to produce all records related to their decisions to hire Emergent as a subcontractor.

The plant, in southeastern Baltimore, has been forced to throw out the equivalent of 75 million doses of Johnson & Johnson’s coronavirus vaccine because of suspected contamination. Deliveries of more than 100 million other doses of both vaccines have been delayed for weeks while regulators check them. The plant has been closed since mid-April while Emergent tries to meet the regulators’ demands to bring its manufacturing up to standard.

The congressional panels began a joint investigation of Emergent’s operations after The New York Times documented months of problems at the Baltimore plant, including a failure to properly disinfect equipment and to protect against viral and bacterial contamination. Among other matters, Democratic lawmakers are looking into whether the company leveraged its contacts with a top Trump administration official, Dr. Robert Kadlec, to win the business of vaccine production, and whether federal officials failed to oversee the firm’s work.

The investigation is being run by the Committee on Oversight and Reform, headed by Carolyn B. Maloney, a New York Democrat, and the Select Subcommittee on the Coronavirus Crisis, headed by James E. Clyburn, a Democrat from South Carolina.

“We are troubled by the impact Emergent’s manufacturing errors have had on the availability of coronavirus vaccine doses, as well as the potential effect on public perceptions regarding the safety and efficacy of these vaccines,” the lawmakers said in the nearly identical letters to the two vaccine developers. “We are also concerned about the circumstances that led AstraZeneca and Johnson & Johnson to sign contracts with Emergent,” they wrote.

At a congressional hearing last month, Emergent’s founder and executive chairman, Fuad El-Hibri, testified that the Trump administration had been well aware of the risks of relying on the Baltimore plant. “Everyone went into this with their eyes wide open, that this is a facility that had never manufactured a licensed product before,” he said.

Confidential audits obtained by The Times show that both Johnson & Johnson and AstraZeneca — as well as the division of the Department of Health and Human Services that oversees Emergent’s contract — all found deficiencies at the plant last summer. AstraZeneca’s audit said that the firm had not documented that it had mitigated “high risk” hazards of contamination. It also said that Emergent repeatedly loosened monitoring criteria so it appeared to meet them, but even then failed the tests.

Johnson & Johnson’s audit said that the firm’s “contamination control strategy is deficient” and that monitoring reports for bacteria or other contaminants were filed four to six months late. Emergent has said that it takes all such observations seriously and works expeditiously to address them.

The federal government agreed in May 2020 to pay Emergent $628 million, much of that to reserve production capacity at the Baltimore plant. It also signed billion-dollar contracts with Johnson & Johnson and AstraZeneca for the doses that Emergent was supposed to produce, and Emergent signed production contracts with the vaccine developers that were expanded in multiyear agreements in July 2020.

Federal officials have now stripped Emergent of its responsibility to manufacture AstraZeneca’s vaccine, lessening the firm’s payments by at least $18 million a month. The factory is expected to eventually reopen and resume manufacturing Johnson & Johnson’s vaccine.

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