When the first cases of a mysterious, fast-spreading illness arose a little more than a year ago in China, the danger struck some around the world as contained, or at least containable.
But the virus responsible behind the outbreak moved with astonishing speed, crossing continents and bringing the novel coronavirus SARS-CoV-2 to doorsteps around the world seemingly instantaneously.
On March 11, 2020, the World Health Organization had declared a pandemic.
It was the beginning of a trail of death and suffering, the start of a succession of lockdowns across the globe that followed the first, tightly restricted one in China. A year later, more than 118 million cases have been reported around the world, with more than 2.6 million known dead, according to a New York Times database.
On Thursday, Dr. Anthony S. Fauci, the United States’ top expert on infectious diseases, cast a somber look back at the past 12 months,
“It was exactly one year ago this morning that I said, ‘Things are going to get much worse before they get better,’” he said on ABC’s “Good Morning America.” “But I did not realize in my mind even anything close to more than a half a million people having died in this country.”
This time last year, sports around the world came to a halt as a handful of elite athletes started to test positive for the virus. In the United States, over 20 million jobs vanished in just one month, the worst toll since the Great Depression. Food pantries have been swamped, schools have been disrupted, young people have grown anxious and depressed. American life expectancy fell by one year in the first half of 2020.
Now, a year later, the United States leads the world with total known cases and known deaths: The deaths of more than half a million people in the country have been linked to the virus, and more than 28 million people have been infected.
The brunt of the losses has fallen on those groups — Black and Latino people and Native Americans — already deeply disadvantaged in terms of income, health care, safety, education and having enough to eat.
Dr. Rochelle Walensky, the head of the Centers for Disease Control and Prevention, emphasized the inequalities that have defined the response to the pandemic over the last year.
“To move past this pandemic, we must resolutely face these challenges head on and fully embrace the innovations, the new partnerships, and the resilience of our communities that have emerged from this crisis,” Dr. Walensky said Thursday in a statement on the W.H.O. anniversary.
The U.S. federal government, while enabling the rapid development of vaccines with crucial investment and support, has repeatedly struggled with the question of whether to prioritize reopening over caution by limiting support for individuals.
There were other divisions.
Only after bitter debate did pass a $1.9 trillion stimulus bill, which was signed into law by President Biden on Thursday.
For all that, it is, in many respects, a heartening moment.
A year ago, Dr. Fauci said the world was at least a year away from developing a vaccine for the virus, a stretch of time that seemed unbearable. Now, vaccinations are moving at a rapid clip in the United States, with enough doses projected to be available for all American adults by the end of May. And the C.D.C. has issued the first of what it promised to be many guidelines for how vaccinated people can safely return to once-normal routines.
Across the country, the seven-day average of daily new virus cases was 57,400 as of Wednesday — a decrease of 16 percent from two weeks earlier, according to a Times database, and a steep decline from the overwhelming crests earlier this year. But the number of new daily cases remains near the peak of last summer’s surge and is still too high for federal health officials, particularly given concerns about the spread of worrisome virus variants.
Even in a year of loss, when people cut off from others openly pined for human touch, and relationships were forged or broken based on space and time, illness and joblessness, frustration or longing, there have been bright spots.
Dogs and cats were snatched up from shelters; some families were reunited when parents and students unexpectedly spent their days together at home or had the chance to cook a meal together. Artists invented new ways and places to perform; restaurants devised contactless delivery, and sold their supplies when flour and yeast disappeared from grocery shelves.
Eileen Sullivan contributed reporting.
For months, domestic travelers to New York were warned to quarantine upon arrival for as long as two weeks.
But starting April 1, domestic travelers will no longer be required to quarantine, Gov. Andrew M. Cuomo said Thursday, though the state will still recommend they do so as “an added precaution.” The quarantine requirement remains for international travelers, and all travelers must continue to fill out the state’s traveler health form, he said in a statement.
Despite the move, “it is not an all-clear for New Yorkers to let their guard down,” Mr. Cuomo said, adding that people should continue following health precautions, including mask-wearing and social distancing.
As of Wednesday, New York was reporting a seven-day average of 37 new virus cases a day for every 100,000 residents, according to a New York Times database, trailing only New Jersey. (The nation as a whole was averaging 17 new cases per 100,000 people.) New York City is currently adding new cases at a per capita rate roughly three times higher than that of Los Angeles County.
Not long after Mr. Cuomo’s announcement, Mayor Bill de Blasio of New York City said on Thursday at a news conference that the city had not been consulted about the quarantine change. He said he would consult with his health advisers about the potential impact.
“Of course I have concerns about this,” he said. “I think the introduction of the virus from outside has been the biggest and toughest X-factors in this crisis and something to worry about going forward.”
Dr. Mitchell Katz, the city’s public hospitals chief, said the removal of the quarantine requirement was “worrisome,” given the prevalence of virus variants.
Mr. Cuomo first announced the original quarantine rules in June under a joint travel advisory, with neighboring New Jersey and Connecticut, though the states later diverged in specifics of different aspects.
As the virus spread across the country last year, New York’s travel advisory eventually grew to include travelers from dozens of states. Still, the mandatory quarantine was not strictly enforced in many cases, even when New York City installed “traveler registration checkpoints” at bridges and tunnels. In November, the state gave travelers the option to “test out” of the full quarantine.
Travel restrictions vary state to state in the United States, and several states do not have any.
The Centers for Disease Control and Prevention has reiterated that people in the United States should still avoid travel unless necessary.
The agency advises those who do travel to get tested three to five days after travel and to quarantine for a full seven days even if the test returns negative. If individuals don’t get tested, the agency recommends they stay home and quarantine for 10 days after travel. Earlier this week, the agency released guidance on some activities that fully vaccinated people can resume while staying local.
Mihir Zaveri contributed reporting.
Hungary has agreed to pay about $36 a dose for Covid-19 vaccines made by Sinopharm, a Chinese state-owned vaccine maker, according to contracts made public by a senior Hungarian official on Thursday. That appears to make the Sinopharm shot among the most expensive in the world.
Hungary has agreed to buy five million doses of the Sinopharm vaccine, priced at 30 euros ($36) each, according to contracts that Prime Minister Viktor Orban’s chief of staff, Gergely Gulyas, uploaded to his Facebook page. That price far surpasses what the European Union has agreed to pay for vaccines from Western manufacturers.
The European Union has said it would pay €15.50 per dose for the Pfizer-BioNTech vaccine, according to Reuters, which cited an internal E.U. document. For AstraZeneca, it agreed to pay $2.15 per dose, according to Belgium’s budget secretary.
The contracts that Mr. Gulyas published also show that Hungary, which has recorded nearly half a million cases and more than 16,000 deaths, has agreed to pay $9.95 per dose for the Russian Sputnik-V vaccine.
Hungary was one of the few European countries that signed a deal with Sinopharm, which promoted itself to developing countries at a time when many richer nations were hoarding doses by Western drugmakers like Pfizer and Moderna. A major selling point was Sinopharm’s immense manufacturing capacity; it has said it can make up to 3 billion doses by the end of this year.
The Sinopharm price is extraordinary in part because the company, unlike the Western vaccine makers, has not published detailed data from Phase 3 trials.
Sinopharm is mass-producing two vaccines. It says the first, made in conjunction with the Beijing Institute of Biological Products, has an efficacy rate of 79 percent, and that the second, made with the Wuhan Institute of Biological Products, is 72.5 percent effective.
Adam Liptak contributed reporting.
Four former U.S. presidents and their first ladies appear in a new public service campaign with one single plea to Americans: Get vaccinated.
The ads feature former Presidents Jimmy Carter, Bill Clinton, George W. Bush and Barack Obama, getting vaccine jabs. Their wives — Rosalynn Carter, Hillary Clinton, Laura Bush and Michelle Obama — also appear.
The ads urge all Americans to get their shots when the opportunity arrives.
“This vaccine means hope,” Mr. Obama says. “It will protect you and those you love from this dangerous and deadly disease.”
“In order to get rid of this pandemic it’s important for our fellow citizens to get vaccinated,” says Mr. Bush.
They spoke of the longing so many feel to get back to normal.
“I want to be able to go back to work and to move around,” says Mr. Clinton.
“To visit with Michelle’s mom,” says Mr. Obama. “To hug her, and see her on her birthday.”
Mr. Bush says he is “really looking forward to going to opening day in Texas Ranger Stadium with a full stadium.”
Mr. Carter says, “I’m getting vaccinated because we want this pandemic to end as soon as possible.”
The only ex-presidential couple not in the ad campaign is Donald and Melania Trump.
Mr. and Mrs. Trump quietly received their vaccines in January before leaving the White House. Later that month, Mr. Trump appeared at the CPAC political conference in Orlando, Fla., where he encouraged people to go get vaccinated.
Mr. Trump’s private approach came as a number of his supporters have expressed resistance to the vaccine. Many other prominent figures have tried setting an example by getting the shot in public.
The two ads are part of a broad promotional effort to combat Covid-19 vaccine skepticism that launched in February, backed by the nonprofit adverting group Ad Council and a coalition of experts known as the Covid Collaborative. Public service announcements will appear in English and Spanish on television, social media and other platforms.
More than 300 companies, community groups and public figures contributed to the $52 million push, as did the Centers for Disease Control and Prevention.
“We urge you to get vaccinated when it’s available to you,” says Mr. Obama.
“So roll up your sleeve and do your part,” says Mr. Bush.
“This is our shot,” says Mr. Clinton.
“Now it’s up to you,” concludes Mr. Carter.
As vaccine production and deliveries and inoculations ramp up, a growing number of U.S. states are allowing ever more people to get vaccinated, providing optimism for those who have been waiting for their moment.
Anyone age 16 and older who lives or works in Alaska became eligible on Tuesday evening after the state became the first in the country to allow the maximum possible number of residents access to a vaccine. Next week, Texans age 50 and older will be eligible, the state’s health department announced on Wednesday, the same day Gov. Brian Kemp of Georgia said that people in that state over 55 would be able to get a shot next week.
New Yorkers age 60 and older became eligible on Wednesday, with Gov. Andrew M. Cuomo citing increased supply from the federal government. The governors of Minnesota and Ohio also said this week that they would open eligibility to larger groups of residents.
Minnesota’s governor, Tim Walz, said his state “moved quickly to use more vaccine from the federal government” and was set to meet its goal this week of vaccinating 70 percent of people 65 and older in the state. That allowed him to expand eligibility to the state’s next two phases at the same time — and “weeks ahead of schedule.”
And at least 37 states, as well as Washington, D.C., are now allowing some residents with certain health problems to receive vaccines, according to a New York Times survey, though the conditions that confer access in one state may not do so in another.
The pace of vaccinations has picked up to the point where the daily average of individual shots has reached about 2.17 million a day. On March 6, the Centers for Disease Control and Prevention reported that 2.9 million shots had been delivered.
Should the pace hold or even increase, the adult American population of about 260 million could be fully vaccinated within months, either by Johnson & Johnson’s single-dose vaccine or by the two-dose series made by Pfizer-BioNTech and Moderna. About 62.5 million Americans have received at least one dose and about 32.9 million of that number have been fully vaccinated, according to the C.D.C.
President Biden has steadily moved up the nation’s inoculation timeline as the vaccine makers have increased production — in Johnson & Johnson’s case, by entering a partnership with a longtime rival, Merck. After announcing last week that the U.S. would have enough vaccine available by the end of May for every American adult, on Wednesday, Mr. Biden said that he was directing the federal government to secure an additional 100 million doses of Johnson & Johnson’s vaccine.
The White House said that the additional doses could help the country begin to vaccinate children after the necessary clinical trials are completed. The doses could also, if necessary, be used as boosters or be reformulated to combat emerging variants of the virus.
Utah is making all adults eligible for the vaccine on April 1 for more local reasons. After the state’s Republican-controlled legislature moved to end the state’s mask mandate, Gov. Spencer Cox, also a Republican, “worked with them to push the date back to get as many people vaccinated as possible” beforehand, a spokeswoman for the governor, Jennifer Napier-Pearce, said in a statement on Tuesday. Utah’s mask requirement will end April 10, at which point the state plans to have 1.5 million doses available, she said.
Local authorities have also opened eligibility to wider populations. At some clinics in the Navajo Nation, which underwent harsh lockdowns this summer and suffered from a surge in cases, anyone 16 and older can get a vaccine. And in Gila County, Ariz., any resident over the age of 18 can walk into a clinic and get a shot.
But vaccine hesitancy remains a potential obstacle to the nation’s energized vaccination campaign. Health officials in Alaska have said that hesitancy, combined with confusion about eligibility, had left unfilled appointments, which may have factored into the governor’s decision to swing the doors to the vaccine wide open.
While Alaska has fully vaccinated 16 percent of its population, the highest rate in the country, according to a New York Times database, the state ranks 46th in vaccine administration, having used only 69 percent of its supply.
President Biden used his prime-time address Thursday sketch out the next phase of his pandemic response, including deploying 4,000 active-duty troops to help with coronavirus vaccination; spending nearly $40 billion on screening to open up schools; scaling up efforts to track worrisome new variants; and launching a new website in early May to make it easier for people to get their shots.
Mr. Biden also announced that he is directing states to make the vaccine available to all adults no later than May 1, and said that if Americans continued to abide by social distancing and other public health guidelines, they could expect some semblance of a return to normalcy by July 4. He said people could look forward to gathering — if in small groups — for neighborhood cookouts and the like.
Mr. Biden’s remarks came just hours after he signed a $1.9 trillion coronavirus relief package, his first major legislative achievement as president. Senior administration officials previewed the address to reporters late Thursday afternoon.
The speech, coming one year to the day after the World Health Organization declared that the world was in pandemic, gave Mr. Biden an opportunity to lay out the specifics of his plan to bring the nation out of the worst public health crisis in a century. The president also used the occasion to offer Americans a sense of hope as the country emerges from what he has repeatedly described as a “dark winter.”
Mr. Biden’s decision to invoke the Fourth of July holiday marked the first time that he has offered a specific date for when things might look more like normal. One senior official said that as the nation approaches Independence Day, the federal Centers for Disease Control and Prevention will provide public health advice to guide Americans “as they travel, participate in small gatherings and go to work and houses of worship.”
Earlier Thursday, the administration announced that it intends to deliver coronavirus vaccine to an additional 700 of the nation’s 1,300 community health centers, bringing the total number of centers involved to 950. The federal government’s pharmacy vaccination program will also be expanded, officials said, to include more than 20,000 pharmacies across the nation.
Some of the steps Mr. Biden is taking are directly related to provisions in the stimulus package. The bill includes $1.7 billion that will allow the administration to dramatically scale up genomic sequencing of samples of the virus — a task that is essential to tracking and staying ahead of new variants.
The bill also includes $130 billion for school reopening, which will help school departments pay for supplies and staff to comply with the C.D.C.’s reopening guidelines. The federal Department of Health and Human Services will also award $650 million in what officials described as an “initial investment” to expand testing in elementary and middle schools.
Caving in to a pent-up demand to party, college students across the country have taken to bars, beaches and backyards in recent weeks — and drawn crackdowns from their schools, as administrators try to keep the coronavirus at bay on campus.
“Sadly, it has happened again — a group of students flagrantly flouted the rules,” wrote Brandi Hephner LaBanc, the vice chancellor for student affairs at the University of Massachusetts Amherst, after more than 200 students gathered last weekend for a pre-St. Patrick’s Day tradition called the Blarney Blowout.
Police officers broke up the crowd, and university officials said that they would place identified students on suspension and temporarily remove them from dorms.
At the University of Michigan, the authorities locked 375 students out of nonresidential buildings because they failed to comply with testing requirements. Penn State punished four fraternities — suspending two through 2024 — for holding parties.
Purdue University said it was investigating and might expel 12 students for Covid rule violations.
With traditional spring break dates approaching, the University of California, Davis said it would pay students $75 to stay on campus, while other colleges have swapped the usual weeklong breaks for individual days off scattered throughout the semester. Still, officials in Florida, Texas and elsewhere are anticipating large crowds in the coming weeks.
“This year, the confluence of other places closed or cold, cheap flights and discounted rooms, and a pandemic which is still very much active, creates new challenges,” Mayor Dan Gelber of Miami Beach said in an email. He imposed limits on alcohol consumption and the number of people at beaches and restaurants, along with social-distancing requirements and a curfew.
The pandemic in the United States, now more than a year old, is starting to hit some calendar milestones for a second time, including St. Patrick’s Day parades across the country. The sudden cancellation of the parades last year was one of the first big signs of how disruptive the pandemic would be to normal life in the U.S.
Though many states and cities have been tentatively loosening various Covid restrictions lately, most places have not cleared the way for a resumption of parades, which can be among the most ruthlessly effective kinds of super-spreading events.
So the St. Patrick’s Day parade in Chicago has been canceled, again; the parade in Boston canceled, again; the one in Philadelphia, canceled, again. The parade in New York City, intent on retaining its distinction as the oldest uninterrupted St. Patrick’s Day parade in the world, will once again be largely ceremonial and very low-profile, with a small group walking up Fifth Avenue at an unannounced time very early in the morning — that is, if the city and state approve doing anything at all.
Some places are putting a spin on the commemorations. The 37th annual parade in St. James, on Long Island, is now going to be held by car; the one in Hilton Head, S.C., is moving to the water; and the one in Pittsburgh is moving to the fall (maybe). A drive-in Celtic rock concert is planned in Dublin, Calif.; a virtual 5K run in Naperville, Ill.; and a day of green beer in plastic cups being delivered by masked servers between plexiglass screens at McGillin’s Olde Ale House in Philadelphia.
Last year, bars from Chicago to New Orleans were packed on the weekend before St. Patrick’s Day despite the cancellation of local parades, prompting stern admonitions from mayors and governors. This year, officials are pleading with people to stay at home, or at least to be vigilant when they are out.
“We are not at a point where we can start having major St. Patrick’s Day celebrations,” Dr. Allison Arwady, the commissioner of the Chicago Department of Public Health, said to reporters in a recent briefing.
Still, not everyone is resigned to laying low for another year.
In the town of Erin, Wis., population around 3,800, the short-notice cancellation of last year’s parade, the 40th, was a heartbreaker: Floats had already been prepared, and past parade kings and queens were scheduled to appear. This year, local officials and volunteers are determined to do everything they can to make a parade happen.
“It was by the end of January that we decided,” said Dennis Kenealy, a retired lawyer who is chairman of the town board. “If we can’t pull together all the health precautions, we would still cancel it. But let’s go ahead and try.”
Mr. Kenealy listed reasons the organizers felt comfortable going forward: The parade is outdoors, along a stretch of highway; spectators can line up to watch from their cars; a Wednesday morning parade will probably draw fewer people than past years; and Wisconsin is currently doing better than most of the country, both in the percentage of people fully vaccinated and the rate of newly reported cases. A statewide mask mandate remains in effect.
Still, Mr. Kenealy said he hoped that holding one of the very few St. Patrick’s Day parades anywhere this year would not make Erin a magnet for big crowds from out of town.
“I would hope not too many show up for that reason,” Mr. Kenealy said. “I mean, we’re out here pretty far. And we’re not offering an awful lot, nothing that you couldn’t see somewhere else.”
Anxiety spread through Hong Kong’s banking community on Thursday after a cluster of Covid-19 cases that began at a gym frequented by finance professionals grew to include other gyms and at least one international school. The cluster of cases raised the threat of a broader outbreak in the city just as it is emerging from a lengthy period of pandemic restrictions.
More than 200 people who recently used Ursus Fitness, a gym that is popular among expatriates, were contacted by the government this week, and more than 100 people were sent to government quarantine facilities, according to a spokesman for the Department of Health.
In an email to its members, Ursus said five employees and one client had tested positive for the coronavirus. Another popular gym, H-Core, said in a Facebook message on Wednesday that at least one of its trainers had tested positive as well.
The people quarantined by the government included employees at several international banks. An employee at Credit Suisse and another at BNP Paribas tested positive. HSBC emptied one of the floors in its main office building for deep cleaning after an employee there received a preliminary positive test result, according to a memo seen by the New York Times. Several banks cautioned employees to work from home.
International schools, which enroll expatriates’ children, were forced to close their campuses. The French International School said an employee at its Tseung Kwan O campus tested positive.
Hong Kong has some of the most restrictive quarantine measures in the world. People who have been in close contact with someone who has tested positive are required to stay in government facilities for two weeks. Residents returning to Hong Kong from outside of China must quarantine for 21 days in a hotel.
Partly as a result, Hong Kong has kept the virus largely in check, with only about 11,100 cases since the pandemic began — fewer than New York has reported just in the last four days.
The Hong Kong government announced 22 new coronavirus cases on Thursday. A spokesperson said that 17 of the most recent cases were linked to the Ursus gym.
Facing the nation’s first widespread coronavirus outbreak, some of Washington State’s top leaders quietly gathered on a Sunday morning last March for an urgent strategy session.
The virus had been rampaging through a nursing home in the Seattle suburbs. By the time the meeting began, the region had recorded most of the nation’s first 19 deaths. New cases were surfacing by the hour.
As the meeting’s presentation got to the fifth slide, the room grew somber. The numbers showed a variety of potential outcomes, but almost every scenario was a blue line pointing exponentially upward.
“My God, what on earth is going to happen here?” the King County executive, Dow Constantine, said he was thinking as those in the room, increasingly uneasy about meeting in person, left the pastries untouched.
That gathering, three days before the World Health Organization declared a pandemic last March 11, set off a rush to contain the virus that included some of the country’s earliest orders to cancel large events, shutter restaurants and close schools, all in the hope that the dire possibilities in front of them would not come to pass.
One year later, the Seattle area has the lowest death rate of the 20 largest metropolitan regions in the country. If the rest of the United States had kept pace with Seattle, the nation could have avoided more than 300,000 coronavirus deaths.
During a year in which the White House downplayed the virus and other political leaders clashed over how to contain it, Seattle’s success illustrates the value of unified and timely strategies: Although the region’s public health experts and politicians grappled behind the scenes about how to best manage the virus, they came together to present a united front to the public. And the public largely complied.
“We could not afford to have mixed messages,” said Jenny Durkan, Seattle’s mayor.
The restrictions that have been in place off and on for the better part of a year have brought widespread disruption to lives and the economy. But as governors elsewhere have cited the economy as a reason to ease lockdowns, Seattle’s success showed that an alternative pathway was doable: Amid widespread economic turmoil, the state’s unemployment rate has been about average nationally, outperforming some places that have pressed ahead with wider reopenings, including Arizona and Texas.
There are numerous factors that have shaped the trajectory of the pandemic both locally and nationally. In part, public health experts said, Seattle may have benefited from its demographics: a healthy population living in small households and a lot of workers able to do their jobs from home. The city may have also have won more public support for the crackdowns from the shock of experiencing the nation’s first publicized deaths. The high humidity may have helped, scientists say, although the cold weather and gray skies probably did not.
Researchers said Seattle also profited from its network of research and philanthropic organizations focused on global health, politicians willing to listen to them, businesses that emptied their offices early and residents who repeatedly indicated a willingness to upend their lives to save others. Even as the year wore on, and the region’s case numbers were among the lowest in the nation, a survey found that Washington residents were still the most likely to stay home for Thanksgiving.
Ali Mokdad, a professor of health metrics sciences at the Seattle-based Institute for Health Metrics and Evaluation, said he was convinced the Seattle model could have been replicated, positively affecting the trajectory of the virus across the country.
Instead, he said, state after state reopened sooner than appropriate and members of the public ignored health advice that at times was undermined by conflicting messages from political and business leaders. Seattle, he said, shows what could have been.
“We have so many lessons we have learned here,” Dr. Mokdad said. “Unfortunately, not many people were listening.”
Health authorities in three European countries on Thursday suspended use of AstraZeneca’s vaccine because of concerns that it might increase the risk of blood clots, but emphasized that they were taking action as a precaution and that there is no evidence of any causal link.
Denmark acted after a 60-year-old woman who received a shot died after developing a blood clot. Several other European countries had recently stopped using doses from the same batch of the vaccine after some reports of severe blood clots, and European drug regulators are investigating.
In the flurry of suspensions on Thursday, Norway and Iceland followed Denmark’s lead. Italy and Romania also paused shots, but only from a different batch of the vaccine than the one that had raised concerns elsewhere.
Public health experts expect medical conditions to turn up by chance in some people after they get any vaccine. In the vast majority of cases such illnesses have nothing to do with the shots. Most other countries where the vaccine has been given to many millions of people have not reported similar red flags.
The suspension comes amid a stumbling vaccine campaign across the European Union, where AstraZeneca has fallen short of its original supply commitments. That has been further complicated by a holdup in the United States: Tens of millions of doses of the vaccine are sitting idly in American manufacturing facilities, awaiting results from its U.S. clinical trial while countries that have authorized its use beg for access.
AstraZeneca has asked the Biden administration to let it lend American doses to the European Union, but the administration, for now, has denied the request, one official said.
As of Wednesday, 30 cases of obstructive blood clots had been reported among nearly five million people vaccinated with the AstraZeneca vaccine in the European Economic Area — a rate no higher than in the general population, the European Medicines Agency said.
The agency, Europe’s main drug regulator, said there was no indication that the vaccine “has caused these conditions” and that its benefits outweigh any risks.
Gonzalo Viña, a spokesman for AstraZeneca, said the company’s data have not turned up clotting issues. “An analysis of our safety data of more than 10 million records has shown no evidence of an increased risk of pulmonary embolism or deep vein thrombosis in any defined age group, gender, batch or in any particular country,” he said.
Blood clots, particularly if they are large, can damage tissue or organs like the lungs, heart or brain. Severe cases can be fatal, but people with small clots can often be treated outside of a hospital with prescription drugs.
Denmark’s drug regulator halted all use of the vaccine for at least 14 days. Health officials say they want to err on the side of safety.
Over the weekend, Austria suspended use of that same batch after severe blood clots turned up in several people who received those doses. One person died 10 days after vaccination. Another is now recovering after being hospitalized.
Estonia, Lithuania, Luxembourg and Latvia followed Austria’s lead in suspending use of that batch, though they will continue to inoculate their citizens with AstraZeneca doses from other batches.
More than 70 countries have authorized the vaccine, with the notable exception of the United States, where regulators are waiting on data from a large clinical trial there expected in the next few weeks. A decision from the Food and Drug Administration on whether to authorize AstraZeneca’s vaccine appears to be more than a month away.
The Biden administration’s hesitation about parting with the vaccines is at least partly related to uncertainties over the vaccine supply. Vaccine production is notoriously complex and delicate, and problems like mold growth can interrupt a plant’s progress.
President Biden on Thursday dramatically expanded the ways Americans can get vaccinated and the pool of people who can administer shots, moves enabled in part by new funding in the American Rescue Plan. The changes, he pledged in a prime-time address to the nation, would mean “no more searching day and night for an appointment for you and your loved ones.”
Here’s a look at what the Biden administration is doing to offer more access.
Centralizing how you can find a vaccine.
By May 1, when Mr. Biden directed that states should have opened up eligibility for every adult in the United States, the federal government will debut a vaccine finder website that guides people to sites near them offering shots.
By the same date, the administration will launch a call center with a 1-800 number to assist those who might not have internet access in finding a vaccine.
For states that sponsor vaccine appointment websites, the administration will assign staff in technical support jobs to help improve the sites’ performance.
Opening more vaccination sites
In the next six weeks, the administration will send vaccines to up to 700 more community health centers that typically serve lower-income patients, bringing the total number of those sites serving as vaccination centers to 950.
More than 20,000 pharmacies will now administer the shots as part of the federal government’s pharmacy vaccine program, double the number that have so far participated.
The administration is more than doubling the number of federally run mass vaccination sites, settings that the White House said would now be able to administer hundreds of thousands of shots a day under the aegis of the Federal Emergency Management Agency, the military and other agencies. At least 4,000 more active duty troops are to be deployed to help the effort.
Expanding the number of people who can administer vaccines
Beginning Friday, a dramatically larger pool of people trained in injections will be eligible to give Covid-19 shots, including dentists, medical students, midwives, optometrists, paramedics, podiatrists and veterinarians.
The Department of Health and Human Services is creating a website for people interested in volunteering to give shots that will help determine if they are eligible to do so.
President Biden signed the $1.9 trillion economic relief package on Thursday afternoon, ushering in an aggressive infusion of federal aid in a far-reaching effort to address the toll of the coronavirus pandemic.
“This historic legislation is about rebuilding the backbone of this country,” Mr. Biden said, “and giving people in this nation, working people, middle-class folks, people who built the country, a fighting chance.”
Mr. Biden had originally been scheduled to sign the bill on Friday, after it had been reviewed again and printed. But the president and his advisers, aware that low- and middle-income Americans are desperate for the round of direct payments that the bill includes, moved up the timeline to Thursday afternoon.
Minutes after Mr. Biden signed relief package, Jen Psaki, the White House press secretary, said, “People can expect to start seeing direct deposits hit their bank accounts as early as this weekend.”
Ron Klain, Mr. Biden’s chief of staff, wrote on Twitter earlier in the day that the enrolled bill had arrived at the White House on Wednesday night, adding, “We want to move as fast as possible.”
He continued, “We will hold our celebration of the signing on Friday, as planned, with Congressional leaders!”
The president signed the measure in the Oval Office hours before he was set to deliver a prime-time televised address on Thursday night, kicking off an aggressive campaign to inform voters of the benefits that are coming to them through the relief package.
The campaign will include travel by the president and Vice President Kamala Harris across multiple states, events that will feature a wide range of cabinet members emphasizing the legislation’s themes, as well as endorsements from Republican mayors, according to administration officials.
The White House’s decision to go out and sell the stimulus package after its passage reflects a lesson from the early months of the Obama administration. In 2009, fighting to help the economy recover from a crippling financial crisis, President Barack Obama never succeeded in building durable popular support for a similar stimulus bill and allowed Republicans to define it on their terms, fueling a partisan backlash and the rise of the Tea Party movement.
Mr. Biden starts with an advantage: The legislation is widely popular in national polling. And it will deliver a series of tangible benefits to low- and middle-income Americans, including direct payments of $1,400 per individual, just as the economy’s halting recovery from the pandemic recession is poised to accelerate.
After his address on Thursday night, Mr. Biden will headline a weekslong public relations effort. He is set to visit the Philadelphia suburbs on Tuesday, and he and Ms. Harris are scheduled to travel to Atlanta next Friday.
President Biden will deliver his first prime-time presidential address at 8 p.m. Eastern on Thursday.
Speaking from the East Room of the White House, he is expected to focus on the coronavirus pandemic as the nation reaches an inflection point: the first anniversary of the World Health Organization’s official declaration of the pandemic, and the day he signed into law a $1.9 trillion relief package. One year into the pandemic, the United States has recorded by far the world’s largest outbreak, with about 530,000 deaths and more than 29 million infections.
The speech is anticipated to be about 20 minutes long, and will be carried on major networks and news cable channels.
The European Union authorized use of the Johnson & Johnson vaccine on Thursday, amid mounting frustration with a sluggish inoculation campaign that has been hobbled by supply shocks and logistics failures, and with global wars over scarce doses ratcheting up.
The European Commission, the bloc’s executive arm, issued the authorization a few hours after the 27-member bloc’s main drug regulator, the European Medicines Agency, approved the vaccine for use in people 18 and up.
The Johnson & Johnson vaccine, which can be stored in regular fridges for up to three months and only requires one shot, is the fourth to be approved by the regulatory agency. Three more vaccines, Novavax, CureVac and Sputnik V, are undergoing a rolling review, a preliminary step that could lead to approval.
The decision on Thursday opens the door for the delivery of 200 million doses of the Johnson & Johnson vaccine to the European Union, under a contract that includes an option for 200 million more.
Those supplies could help speed up the bloc’s vaccination efforts, which have gotten off to a sluggish start. So far, only 6.5 percent of the European Union’s 450 million residents have been inoculated, far behind the rates in Britain, Israel or the United States.
But the first deliveries of Johnson & Johnson vaccine are not expected in Europe before April.
The bloc also said on Thursday that it would extend for another three months, to the end of June, a mechanism that permits member states to prevent the export of vaccines made within the bloc’s borders if the manufacturers have not filled all their orders at home.
Data published Wednesday by The New York Times showed that the European Union has been exporting millions of vaccine doses, even as member nations’ efforts to vaccinate their own citizens have been slowed by shortages and other problems.
The bloc has come under fierce criticism over the mechanism to restrict exports. Accusations of “vaccine nationalism” intensified last week when Italy used the mechanism to block a shipment of doses bound for Australia.
Since the mechanism was put in place in February, officials have approved 249 export permits, covering more than 34 million doses bound for 31 different countries. They were approved “because they did not threaten the contractual arrangement between the E.U. and the vaccine producers,” said Miriam García Ferrer, a spokeswoman for the European Commission. “Only one export has been refused,” she added.
France announced on Thursday that it would relax restrictions on international travel outside the European Union “to adapt to the evolution of the global pandemic.” The move will see an easing of rules on travel to or from several countries and a broadening of the range of “compelling reasons” for which international travel is allowed.
In a statement released on Thursday, the French Foreign Ministry said that, starting on Friday, travel to or from Australia, Britain, New Zealand, Singapore and South Korea will no longer have to be justified by “compelling reasons,” as had been required since January.
As for other non-European Union countries, the range of “imperative reasons” has been broadened to include family reasons such as couples who live in different countries for professional reasons or underage students who attend French schools while their families live abroad.
On Thursday, the French transport minister, Jean-Baptiste Djebbari, also announced that the country would try out a “digital health pass” for travelers with the flag carrier Air France, as part of a monthlong experiment. Passengers to some of France’s overseas territories will have to present a phone app that shows either a recent negative Covid test or a vaccination certificate.
Mr. Djebbari said that the goal was to reduce checks that are slowing boarding and arrival procedures. “It could offer a preview, or at least a large-scale test, of a future ‘travel pass,’” he said.
In other news from around the world:
Thailand on Friday suspended its plans to roll out the AstraZeneca vaccine over concerns that the shot might increase the risk of blood clots. The announcement came hours before Prime Minister Prayuth Chan-ocha was scheduled to be the first person in the country to receive the vaccine, and does not affect Thailand’s ongoing rollout of the Sinovac version. Dr. Yong Poovorawan, a virologist at Chulalongkorn University in Thailand, told reporters that the country’s delay would most likely last only a week or two. “We’re not saying the vaccine is bad,” he said. “We’re postponing it to see if the deaths are related to the vaccine or not.”
Prime Minister Chung Sye-kyun of South Korea said on Friday that coronavirus restrictions would remain in effect until March 28, the Yonhap news agency reported. The rules, which vary by region but include a nationwide ban on most private gatherings, had been set to expire on Sunday. South Korea reported 488 cases on Friday, a three-week high. The government has said it aims to achieve herd immunity by November, but only about 1 percent of the country’s 51 million people have been vaccinated.
The health authorities in Germany registered 14,356 new coronavirus cases on Wednesday, 2,444 more than on the same day a week ago. “We are seeing clear signs: In Germany the third wave has already begun,” said Lothar H. Wieler, the president of the Robert Koch Institute, Germany’s equivalent of the C.D.C. More than half of the new infections in Germany were caused by the B.1.1.7 variant, first discovered in Britain, which is more infectious and thought to be more deadly than the original. In an effort to speed vaccinations, German state and federal health ministers have agreed to let doctors administer vaccines in their offices and clinics by mid-April. Only 6.7 percent of the population in Germany has received at least one vaccine dose.
First Ukraine got caught up in the geopolitics of vaccine distribution between Russia and the West, and struggled to get hold of any doses. Now that it has them, Ukraine faces a new challenge: finding enough people who are willing to be vaccinated.
The country is so plagued by misinformation about Covid-19 that vaccine hesitancy in Ukraine is among the worst in Europe, even among doctors and nurses.
That shows in the slow start for Ukraine’s vaccination program: So far, just over 23,000 people have received a dose, out of a population of 42 million.
Ukrainian news media have carried reports of opened vials of vaccine going to waste at hospitals because not enough willing doctors and nurses could be found to receive the doses.
The United Nations Development Program and UNICEF released a study saying that Ukraine was suffering from an “infodemic,” with social media “flooded with false narratives” about the disease and vaccination.
Ukraine’s tense internal politics are partly to blame.
Opponents of President Volodymyr Zelensky have extended their criticism of him to the two vaccines his administration has put into use — one from Oxford-AstraZeneca and the other from Sinovac — both of which have been shown in clinical trials to be safe and effective.
A former prime minister, Yulia V. Tymoshenko, who now heads an opposition party, introduced a bill in Parliament that implicitly criticized the Zelensky administration’s choices by providing for the government to compensate Ukrainians for any side effects and “protect every Ukrainian from the negative consequences” of the two vaccines.
A former president, Petro O. Poroshenko, said that Ukrainian health care workers were refusing inoculation in the belief that the two vaccines were of poor quality. He used scatological language to describe the vaccines in a speech in Parliament.
The Ukrainian health minister, Maksym Stepanov, said in an interview that the political fight was eroding confidence in vaccination. “Politicians contribute to people’s distrust of vaccines,” he said.
Health officials have said that about one-third of doctors and nurses in the country have already been infected with the coronavirus, and the rest are evenly divided between those who want to be inoculated and those who say they have no intention of taking either of the available vaccines.
Mr. Stepanov said that the widely held negative attitudes were a result of “a lot of fake news spread by members of the anti-vaccination movement.”
Monoclonal antibody treatments sharply cut hospitalizations and deaths among high-risk Covid-19 patients, according to two separate sets of clinical trial results announced on Wednesday, the latest evidence that such drugs can prevent bad outcomes when given early.
Vir Biotechnology and GlaxoSmithKline, the developers of one of the drugs that generated encouraging study results, said that they plan to immediately apply for emergency authorization in the United States and in other countries. The federal government has not yet ordered doses of their drug.
The other announcement came from Eli Lilly, which makes a similar treatment involving a cocktail of two antibody drugs. The federal government authorized that treatment last month and has since ordered 100,000 doses.
If authorized, the treatment from Vir and GlaxoSmithKline would become the fourth of its kind cleared in the United States. That could give doctors more options for people with Covid-19 who are not yet hospitalized but are at high risk of becoming severely ill. But there is also a risk the drug may struggle to find a market, because the federal government has already ordered hundreds of thousands of doses of similar treatments that have been slow to be used.
An independent panel of experts monitoring a study testing the Vir-GlaxoSmithKline treatment recommended ending the trial early, because a preliminary look at the data showed convincing evidence that the treatment was working, the companies said. That early analysis, based on 583 volunteers who had started experiencing symptoms within the last five days, found that those who got the treatment had an 85 percent reduction in their risk of being hospitalized or dying compared to those who got a placebo.
In the clinical trial, the drug was given as an infusion, like the other antibody treatments already available, but it is being tested separately as an injection. If it can eventually receive authorization to be given that way, the door would open for the treatment to be given much more easily than it is now, perhaps even at a drive-through window, said George Scangos, Vir’s chief executive.
Dr. Scangos said he was confident that the drug would be needed. He pointed to preliminary laboratory tests, described in a paper that has not yet been peer-reviewed, suggesting that the treatment would remain potent against concerning coronavirus variants first seen in Brazil, Britain and South Africa.
“I think there’ll be no shortage of Covid patients, unfortunately, for the foreseeable future,” he said.
Antibody treatments consist of artificial copies of the antibodies that are naturally generated when the immune system combats an infection. They got a burst of publicity last fall when they were given to President Donald J. Trump and several other Republican politicians.
But since the first such treatments were authorized in November, they have not been widely used in many places, in part because hospitals were too overwhelmed to prioritize them and also because patients and their doctors didn’t know to ask for them or where to find them. But as awareness has grown, uptake has begun to increase.
The United States is racing through hundreds of thousands of vaccine vials a day, but one of particular importance has found its way into the Smithsonian’s collection, as museums attempt to chronicle the history of the pandemic.
The Smithsonian National Museum of American History announced on Tuesday that it had acquired the vial that contained the first vaccine dose administered in the United States after the shot received Food and Drug Administration authorization.
The vial of the Pfizer-BioNTech vaccine, which was used on Dec. 14 to inoculate Sandra Lindsay, a nurse at a Queens hospital, has been added to the museum’s collection, along with Ms. Lindsay’s white-and-blue scrubs, her vaccination record card and hospital identification badge.
Northwell Health, the New York-based health care provider that administered the vaccine, made the donation and also shared vials from doses of the Moderna vaccine and other inoculation supplies.
“These now historic artifacts document not only this remarkable scientific progress but represent the hope offered to millions living through the cascading crises brought on by Covid-19,” Anthea M. Hartig, the Elizabeth MacMillan director at the museum, said in a news release.
From the very early days of the pandemic, museums have been scrambling to collect artifacts from the fight against the coronavirus, including diary entries, online schoolwork, photographs and first-person accounts.
The National Museum of American History welcomed another item of importance earlier this month when Dr. Anthony S. Fauci, President Biden’s chief medical adviser on Covid-19, presented his colorful three-dimensional model of the coronavirus to the museum’s national medicine and science collections.
The museum, which is still closed to the public because of virus restrictions, has been collecting significant items from the pandemic for a future exhibition exploring American efforts to control and cure illnesses.
In December 2019, the first cases of the coronavirus emerged in China. The World Health Organization declared a global pandemic on March 11, 2020. A year later, the virus has sickened more than 118 million people and taken at least 2,620,900 lives, shattering economies, health services, and families in its wake.
According to a New York Times database, more than 29,247,000 people in the United States have been infected with the virus. On Wednesday, at least 1,477 more coronavirus deaths and 58,530 new cases were reported in the United States.
In the summer, cases soared across the Sun Belt, forcing some states to increase restrictions once more. By the fall, rural hospitals in the Midwest and West were ravaged by the virus, devastating communities.
On a global scale, the outbreak was defined by shifting epicenters of infection: Wuhan, China; Iran; northern Italy; Spain; and New York. But soon the virus had infiltrated nearly every corner of the globe.
After swells in excess mortality in the spring of 2020, most European nations returned to relative normality for the summer. But a second wave took hold in the fall and raged into the winter increasing death tolls again. For some nations, like Belgium and Switzerland, the peaks in mortality during the second portion of the year surpassed those in the spring. Latin America felt the virus’s effects later than many other countries, but it was affected particularly deeply, especially in Brazil and Mexico.
After a historic vaccine race, 10 different vaccines are now available around the world, with more than 325.5 million vaccine doses administered. While most vaccines require two doses, recently the Food and Drug Administration authorized a one-shot vaccine by Johnson & Johnson for emergency use in the United States.
In wealthier nations such as Britain, more than a quarter of the population have received a first vaccine jab, but in less prosperous nations, like many African countries, a single dose has yet to be given.
At the start of March, after six successive weeks of declining infection numbers, the World Health Organization announced that Central and Eastern Europe was in the midst of a resurgence, partly because of new variants of the virus that have cropped up but also because of the easing of restrictions. More than half of the 53 countries in the European region had seen an increase in infections, the W.H.O. said.
The news came as 43 European nations recorded cases of the B.1.1.7 variant first identified in Britain, which has far greater levels of transmissibility. And 26 countries had found cases of the B.1.351 variant first discovered in South Africa, while 15 had reported cases of the P.1 variant first discovered in Brazil.
Not all nations were equally hit by the pandemic, and certain countries did not experience increased mortality in 2020. In Denmark, Finland and Norway, demographers said that the low mortality rate was partly down to a less severe flu season during the winter, along with the fact that those nations were swift to enact tighter restrictions to curb the spread of the virus when outbreaks were less severe.
In Japan, deaths fell last year for the first time in more than a decade, a byproduct of the country’s coronavirus measures. As of Thursday, Cambodia reported its first death from the coronavirus, and with just 1,124 cases recorded in total, it has some of the lowest infection numbers in Asia. The country experienced a spike in infections in late February.
Countries in Southeast Asia, such as Laos, Thailand and Vietnam, have all been successful at managing outbreaks of the virus.
But while the pandemic is starting to recede in some countries, as the rate of new cases has steadily declined since early January, it still impacts every region of the world.
In a recent epidemiological report, the W.H.O. said that global coronavirus cases had increased for the second week in a row as infection rates rise in the Middle East and Africa. But surges seem to be abating in the Americas, Southeast Asia and the Western Pacific.
Over 2.7 million new cases were reported last week, the W.H.O said. Botswana, Jordan, Lebanon and Zambia have seen a surge in infection numbers, while cases in Europe climbed by 4 percent. Global deaths continued to decline, as they have since early February 2021, with fatalities falling in all regions except the Eastern Mediterannean.
Disruptions caused by the coronavirus pandemic prevented nearly 12 million women in 115 countries from gaining access to family planning services over the past year and led to 1.4 million unintended pregnancies, the United Nations reported Thursday.
The findings, in a study released by the United Nations Population Fund, underscored what women’s rights activists have described as the pandemic’s destructive impact on reproductive and maternal health care in many places around the world, particularly among impoverished populations.
Poor and middle-income countries were forced to divert medical resources to patients with Covid-19. And severe restrictions on mobility, aimed at limiting the contagion, meant that many women either could not seek medical care outside the home or feared the risk of traveling.
“Pregnancies don’t stop for pandemics, or any crisis,” said Dr. Natalia Kanem, the executive director of the United Nations Population Fund. Known by its acronym, UNFPA, it is the world’s leading provider of family planning services.
The data in the study was compiled by the UNFPA and Avenir Health, a global health-policy organization.
In the 115 low- and middle-income countries studied, women faced an average disruption in their family planning services of 3.6 months over the past year. The worst disruptions were concentrated in April and May of 2020.
Previous research by the same partners, conducted last May, predicted that three months of lockdown could lead to anywhere between 13 million and 44 million women losing access to contraception.
In what amounts to a public relations coup for China and a solution to a problem for the International Olympic Committee, the I.O.C. president, Thomas Bach, announced on Thursday that China had agreed to provide coronavirus vaccines for any participant requiring one ahead of this summer’s Tokyo Olympics and next year’s Beijing Winter Games.
Bach said the Olympic committee would cover the cost of the vaccines for any Olympic and Paralympic competitors who needed them, and that distribution would take place through existing international agencies. It is unknown how many doses will be purchased or what the program will cost, but if vaccinating participants before they arrive reassures a skeptical public that the Games will not turn into a superspreader event for Japan — where polling has trended strongly against the Games and a national vaccination program is still in its early stages — the payoff for the I.O.C. will be incalculable.
Thursday’s announcement by Bach, elected to a new four-year term a day earlier, will help the I.O.C. resolve a sensitive matter that has been one of the many questions hanging over the Tokyo Games: how to ensure that thousands of visitors to Japan from around the world will be vaccinated when they arrive, and how to do so without making it look as if fit, young, elite athletes and their teams have jumped the line while the global death toll from the coronavirus continues to grow.
For China, the agreement with the I.O.C. — which will include two vaccines for the general population in an athlete’s home country for every one given to an Olympics participant — may help to deflect mounting public scrutiny and criticism about the country’s human rights record ahead of next year’s Beijing Winter Games.
In recent months, China has also made vaccines a tool of its foreign policy, at times exporting precious doses even as it still needs tens of millions of them at home. It has approved four vaccines, and all are in either domestic or foreign use. The country produces single- and two-dose vaccines, but in trials each has produced varying degrees of efficacy.