New York City plans to move about 8,000 homeless people out of hotel rooms and back to barrackslike dorm shelters by the end of July so that the hotels can reopen to the general public, Mayor Bill de Blasio said on Wednesday.
When the pandemic lockdown began last spring, New York City moved the people out of the shelters, where in some cases as many as 60 adults stayed in a single room, to safeguard them from the coronavirus. Now, with social distancing restrictions lifted and an economic recovery on the line, the city is raring to fill those hotel rooms with tourists.
“It is time to move homeless folks who were in hotels for a temporary period of time back to shelters where they can get the support they need,” Mr. de Blasio said at a morning news conference.
The mayor said the city would need the state’s approval to remove the homeless people from 60 hotels, but a spokesman for Gov. Andrew M. Cuomo said that as long as all shelter residents — even vaccinated ones — wore masks, the state had no objections to the plan.
On Tuesday, Mr. Cuomo announced that the state was lifting nearly all remaining coronavirus restrictions and social distancing measures, after more than 70 percent of the state’s adults had received at least a first dose of a vaccine.
The hotels, many of them in densely populated parts of Manhattan, have been a source of friction with neighbors who have complained of noise, outdoor drug use and other nuisances and dangers from the hotel guests.
Wednesday’s announcement signals the end to a social experiment that many homeless people gave high marks to, saying that having a private hotel room was a vastly better experience than sleeping in a room with up to 20 other adults, many of them battling mental illness or substance abuse or both. Some people said they would sooner live in the street.
“I don’t want to go back — it’s like I’m going backward,” said Andrew Ward, 39, who has been staying at the Williams Hotel in Brownsville, Brooklyn, after nearly two years at a men’s shelter. “It’s not safe to go back there. You’ve got people bringing in knives.”
The German company CureVac delivered disappointing preliminary results on Wednesday from a clinical trial of its Covid-19 vaccine, dimming hopes that it could help fill the world’s great need.
The trial, which included 40,000 volunteers in Latin America and Europe, estimated that CureVac’s mRNA vaccine had an efficacy of just 47 percent, among the lowest reported so far from any Covid vaccine maker. The trial will continue as researchers monitor volunteers for new cases of Covid, with a final analysis expected in two to three weeks.
“We’re going to full speed for the final readout,” Franz-Werner Haas, CureVac’s chief executive, said in an interview. “We are still planning for filing for approval.”
CureVac plans to apply for approval initially to the European Medicines Agency. The European Union reached an agreement last year to purchase 405 million doses of the vaccine if the agency authorizes it.
Independent experts, however, said it would be difficult for CureVac to recover. Natalie Dean, a biostatistician at the University of Florida, said that the vaccine’s efficacy rate might improve somewhat by the end of the trial. But because most of the data is already in, it’s unlikely the vaccine will turn out to be highly protective. “It’s not going to change dramatically,” she said.
And with an efficacy rate that low — far less than the roughly 95 percent of competing mRNA vaccines made by Pfizer-BioNTech and Moderna — the results do not bode well for CureVac’s shots getting adopted.
“This is pretty devastating for them,” said Jacob Kirkegaard, a vaccine supply expert at the Peterson Institute for International Economics, a think tank in Washington.
The news was disappointing to experts who had hoped the company could provide vaccines for low- and middle-income countries that don’t have nearly enough. CureVac had some advantages over the other mRNA vaccines, such as keeping stable for months in a refrigerator. What’s more, compared with its competitors, CureVac’s vaccine used fewer mRNA molecules per jab, lowering its cost.
The trial results released on Wednesday were based on data from 135 volunteers who got sick with Covid. An independent panel compared the number of sick people who had received a placebo with those who had received the vaccine. Although the vaccine did seem to offer some protection, the statistical difference between the two groups was not stark, working out to an efficacy rate of 47 percent.
Annual flu shots, by comparison, can reach 40 to 60 percent effectiveness. Both the World Health Organization and the Food and Drug Administration set a threshold of 50 percent efficacy to consider Covid vaccines for emergency authorization. If CureVac were to stay at 47 percent in the final analysis, it would fail to meet that standard.
The results caught scientists by surprise. CureVac’s shots yielded promising results in animal experiments and early clinical trials.
“This one’s a bit of a head-scratcher,” Dr. Dean said.
Dr. Haas blamed the disappointing results on the high number of virus variants in the countries where the vaccine was tested. Out of 124 of the Covid-19 cases that the company’s scientists genetically sequenced, only one was caused by the original version of the coronavirus.
More than half of the cases were caused by variants that have been shown to be more transmissible or able to blunt the effectiveness of vaccines. CureVac’s volunteers were also infected by variants that have yet to be studied carefully. Lambda, which has come to dominate Peru in recent weeks, accounted for 21 percent of the samples.
Dr. Haas said that the results should serve as a wake-up call for the threat that new variants can pose to the effectiveness of vaccines. “It’s a new Covid reality, that’s for sure,” he said.
Moderna and Pfizer-BioNTech were tested last year before variants had emerged, which could partially account for their much higher efficacy rates. Even so, studies have found that their real-world effectiveness only drops moderately in the face of variants.
Dr. Kirkegaard predicted it would be a challenge for CureVac to compete with another Covid vaccine in development, made by Novavax. On Monday, Novavax reported that its vaccine, which doesn’t have to be kept frozen, reached an efficacy of 90 percent in a trial in the United States and Mexico.
“I suspect it will be difficult for them to really get a significant developing-country market,” Dr. Kirkegaard said.
On the night of March 26, 2020, as the coronavirus was engulfing Britain and its leaders were struggling to fashion a response, Prime Minister Boris Johnson ridiculed his government’s health secretary, with a profanity, as totally “hopeless,” according to a text message posted by his former chief adviser.
The WhatsApp message, one of several texts shared on Wednesday by Mr. Johnson’s former aide, Dominic Cummings, reignited a debate over how Britain handled the early days of the pandemic — a period when Mr. Cummings said it lurched from one course to another and failed to set up an effective test-and-trace program.
In riveting testimony before Parliament last month, Mr. Cummings pinned much of the blame for the disarray on the health secretary, Matt Hancock, whom he accused of rank incompetence and serial lying. Mr. Hancock denied the accusations before lawmakers last week. He said it was “telling” that Mr. Cummings had not provided evidence to back up his most incendiary claims.
The WhatsApp messages, and an accompanying 7,000-word blog post, are the former aide’s attempt to do so. They depict a government under relentless stress, racing to secure ventilators and protective gear, scale up a testing program, and settle on the right strategy to prevent the nation’s hospitals from collapsing.
In the text exchange with Mr. Johnson on March 26, Mr. Cummings noted that the United States went from testing 2,200 people a day to 100,000 in two weeks. He said Mr. Hancock was “skeptical” about being able to test even 10,000 a day, despite having promised two days earlier to reach that goal within a few days.
The exchange prompted Mr. Johnson’s profane description of Mr. Hancock. Later, Mr. Johnson was severely ill with Covid-19 and hospitalized, forcing his foreign secretary, Dominic Raab, to lead in his absence. Mr. Cummings said Mr. Raab did a far better job leading the government’s response to the pandemic, than Mr. Johnson, with whom he helped elect but has since had a bitter falling out.
More than 600,000 people in the United States are known to have died of Covid-19 as of Wednesday, according to data compiled by The New York Times — a once-unthinkable number, 10 times the death toll that President Donald J. Trump once predicted. The milestone comes as the country’s fight against the coronavirus has made big gains but remains unfinished, with millions not yet vaccinated.
“It’s a tragedy,” said Stephen Morse, a professor of epidemiology at the Columbia University Medical Center. “A lot of that tragedy was avoidable, and it’s still happening.”
As many Americans celebrate the beginning of summer and states have relaxed restrictions, the virus is still killing hundreds of people daily, nearly all of them unvaccinated, experts say. Though the sheer number of total deaths in the United States is higher than anywhere else, the country’s toll is lower per capita than in many European and Latin American countries, including Peru, Brazil, Belgium and Italy.
The first known Covid death in the United States occurred in February 2020. By the end of that May, 100,000 people had been confirmed dead, an average of more than 1,100 Covid deaths each day. The pace kept accelerating: It took close to four months for the nation to log another 100,000 Covid deaths; the next, about three months; the next, just five weeks. By late February 2021, just over a month later, half a million Americans had died with Covid.
The most recent 100,000 deaths came more slowly, over about four months. About half of all Americans are protected with at least one dose of a vaccine, and public health experts say that has played the central role in slowing the death rate.
President Biden, speaking at a news conference in Brussels on Monday, said that he felt for everyone who had lost a loved one to the virus.
“Please get vaccinated as soon as possible,” he said. “We’ve had enough pain.”
Since mid-April, the U.S. pace of inoculations has dropped sharply, despite Mr. Biden’s July 4 deadline to have 70 percent of U.S. adults at least partly vaccinated. It’s the remaining unvaccinated population that is driving the lingering deaths, experts say. And the virus is still raging in other countries, including India and in parts of South America.
“Until we have this under control across the world, it could come back and thwart all the progress we’ve made so far,” said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, which represents state health agencies. “I’m worried about the people who are not taking advantage of these vaccines. They’re the ones who are going to bear the brunt of the consequences.”
Deaths from Covid have declined by about 90 percent in the United States since their peak in January, according to provisional data from the Centers for Disease Control and Prevention. But about half of Covid deaths at the end of May were of people aged 50 to 74, compared with only a third of those who died in December, according to a recent New York Times analysis. Older white people are driving the shifts in death patterns, and Black people across most age groups saw the smallest decrease in deaths compared with other large racial groups.
Cumulative vaccination rates among Black and Hispanic people continue to lag behind other groups.
In Wayne County, Mich., home to Detroit, vaccine hesitancy is a major problem, said Dr. Teena Chopra, the medical director of infection prevention and hospital epidemiology at the Detroit Medical Center. In May, all of her Covid-19 patients were either unvaccinated or had received only one vaccine dose. Several have died, she said, and patients with the virus were still being admitted.
“It makes me feel very frustrated and angry because getting people vaccinated is the only way to end the pandemic,” Dr. Chopra said.
Denise Lu, Daniel E. Slotnik, Julie Bosman and Mitch Smith contributed reporting.
This is the age of “vaccine diplomacy.” It is also the era of its bitter, mudslinging opposite.
For months, Taiwan has been unable to purchase doses of the BioNTech coronavirus vaccine, and the island’s leaders blame “Chinese intervention.” China, which regards Taiwan as its own territory, calls this accusation “fabricated out of nothing.”
It is unclear what steps, if any, the government in Beijing has taken to disrupt Taiwan’s dealings with BioNTech, the German drugmaker that developed the vaccine with Pfizer. BioNTech declined to comment.
But the crux of the problem is that a Chinese company claims the exclusive commercial rights to distribute BioNTech’s vaccine in Taiwan. And for many people in the self-governing democracy, buying shots from a mainland Chinese business is simply unpalatable.
Less than 5 percent of Taiwan’s 23.5 million people have been vaccinated so far, and the impasse is exacerbating Taiwan’s vaccine shortage as the island confronts its first major outbreak of Covid-19 since the start of the pandemic. It is a bleak illustration of how deeply entrenched the long-running conflict across the Taiwan Strait has become, with a degree of mutual distrust that not even a global medical emergency can allay.
When Bruce Springsteen walks onstage on June 26 in the first show to return to Broadway, his audience will have had to prove that they’ve been vaccinated. And those inoculations have to be with vaccines approved by the U.S. Food and Drug Administration: Moderna’s, Pfizer-BioNTech’s, or Johnson & Johnson’s.
That is bad news for the Boss’s fans in Canada, where 1.7 million people have received the AstraZeneca vaccine. “Burn in the U.S.A.,” The Toronto Star headlined its report on Wednesday.
New York’s St. James Theater, where Mr. Springsteen will perform, describes the show as “a solo acoustic performance” and “an intimate night with Bruce, his guitar, a piano and his stories.” On Tuesday the theater announced that it would only accept proof of F.D.A.-approved vaccines “at the direction of New York State.”
Attendees under 16 are exempt from the requirement but must be accompanied by a fully vaccinated adult and show proof they tested negative on a recent coronavirus test. There are no exceptions for people who are unable or unwilling to be vaccinated.
The two-hour-plus show debuted in 2017 at the Walter Kerr Theatre and ran for 236 performances. Like those shows, the coming series will run Tuesday through Saturday. It is a demanding schedule for a septuagenarian rock star, but Mr. Springsteen has said he has no plans on slowing down after six decades onstage, and that playing live shows remained “an experience that cannot yet be simulated.”
“I’m at a point in my playing life and artistic life where I’ve never felt as vital,” he told The New York Times last year.
With other Broadway shows also returning in September, the vaccination rules governing Mr. Springsteen’s show could portend trouble for visitors to New York who cannot present proof that they have received a U.S.-approved vaccine. The Toronto Star said it could “be just the beginning of bureaucratic vaccine woes, as the world starts to reopen with a patchwork of different approved shots.”
Warmer weather and low coronavirus case numbers are raising hope in some countries in Europe that vaccine rollouts could usher in a more normal summer after an erratic year of lockdowns.
France announced on Wednesday, sooner than expected, that it was ending a mandate on mask-wearing outdoors and lifting a nighttime curfew that has lasted for months — an increasingly unpopular measure as days grew longer and cafes reopened.
“The health situation in our country is improving, and it is improving even faster than what we had hoped,” Jean Castex, the French prime minister, said in making the announcement, which some political opponents noted came a few days before regional elections.
In addition, tourists from the United States may be allowed back into European Union countries as early as Friday — a move crucial to lifting Europe’s battered economies. On Wednesday, ambassadors of the European Union indicated their support for adding the United States to a list of countries considered safe from an epidemiological point of view, a bloc official confirmed, though no official announcement is expected until Friday.
The traffic will be one-way, however, unless the United States lifts its ban on many European travelers, which was announced on Jan. 25 of this year, days after President Biden took office. The U.S. barred noncitizens coming from many countries around the globe, including the Schengen area of Europe, the United Kingdom and the Republic of Ireland.
In Europe, however, low infection numbers in many countries in recent weeks have been taken as an optimistic sign. But that is not the case everywhere. In Britain, officials are keeping watch for the Delta variant, which has spurred a rise in cases, and on Monday delayed by a month a much-anticipated reopening that had been heralded as “freedom day.”
And in Moscow, a surge of cases prompted a shutdown, leaving Russian officials pleading with residents to get vaccinated.
Still, the move to open up the European Union countries to U.S. tourists signaled a wider hope that the bloc is on a pathway to normality.
Health policy in the European Union is ultimately the province of member governments, so each country has the right to decide whether to reopen, and to tailor the travel measures further — adding requirements for P.C.R. tests and quarantines, for example.
Travel from outside the bloc was practically suspended last year to limit the spread of the coronavirus, with the exception of a handful of countries that fulfilled specific criteria, such as low infection rate, and their overall response to Covid-19. Until Wednesday, the list contained a relatively small number of nations, including Australia, Japan and South Korea, but more are coming, including Albania, Lebanon, North Macedonia and Serbia.
Some countries heavily dependent on tourism, like Spain and Greece, have already reopened to external travelers. Germany also lifted more restrictions this month, announcing it would remove a travel warning for locations with low infection rates from July 1.
The European Commission recommended last month that all travelers from third countries who were fully vaccinated with shots approved by the European Medicines Agency or by the World Health Organization should be allowed to enter without restrictions.
The loosening of travel measures was enabled by the fast pace of vaccination in the United States and by the acceleration of the inoculation campaign in Europe, and bolstered by advanced talks between the authorities on how to make vaccine certificates acceptable as proof of immunity.
The European Union is finalizing work on a Covid certificate system, which is supposed to be in place on July 1. Fifteen member countries already started issuing and accepting the certificate ahead of schedule this month. The document records whether people have been fully vaccinated against the coronavirus, recovered from Covid or tested negative within the past 72 hours, and it would eventually allow those who meet one of the three criteria to move freely across the 27 member countries.
Travelers coming from outside the bloc would have the opportunity to obtain a Covid certificate from an E.U. country, the European Commission said. That would facilitate travel between different countries inside the bloc, but would not be required for entering the European Union.
The Biden administration, planning for the possibility that Americans could need booster shots of the coronavirus vaccine, has agreed to buy an additional 200 million doses from the drugmaker Moderna with the option to include any developed to fight variants as well as pediatric doses.
The purchase, with delivery expected to begin this fall and continue into next year, gives the administration the flexibility to administer booster shots if they prove necessary, and to inoculate children under 12 if the Food and Drug Administration authorizes vaccination for that age group, according to two administration officials not authorized to discuss it publicly.
Experts do not yet know whether, or when, booster shots might be necessary. The emergence of variants in recent months has accelerated research on boosters, and the current vaccines are considered effective against several variants, including the Alpha variant which was first identified in Britain and which became dominant in the United States.
And this week, U.S. health officials classified the Delta variant, which was first found in India, as a “variant of concern,” sounding the alarm because it spreads rapidly and may cause more serious illness in unvaccinated people. Concern over Delta prompted England to delay lifting restrictions imposed because of the pandemic.
Moderna, a company that had no products on the market until the F.D.A. granted its Covid vaccine emergency authorization last year, uses mRNA platform technology to make its vaccine — a so-called “plug and play” method that is especially adaptable to reformulation. Last month, the company announced preliminary data from a clinical trial of a booster vaccine matched to the Beta variant, first identified in South Africa; the study found an increased antibody response against Beta and Gamma, another variant of concern first identified in Brazil.
In announcing the purchase on Wednesday, Moderna said it expected to deliver 110 million of the new doses in the fourth quarter of this year, and 90 million in the first quarter of 2022. The option brings the total U.S. procurement of Moderna’s two-shot vaccine to 500 million doses.
“We appreciate the collaboration with the U.S. government for these additional doses of the Moderna Covid-19 vaccine, which could be used for primary vaccination, including of children, or possibly as a booster if that becomes necessary to continue to defeat the pandemic,” Stéphane Bancel, Moderna’s chief executive officer, said in a statement.
“We remain focused on being proactive as the virus evolves by leveraging the flexibility of our mRNA platform to stay ahead of emerging variants,” he said.
Under its existing contract with Moderna, the federal government had until Tuesday to exercise the option to purchase doses for future vaccination needs at the same price it is currently paying — about $16.50 a dose. Similar conversations are underway with Pfizer-BioNTech, which also makes a two-dose mRNA vaccine, but no agreement has been reached, one of the officials said.
State health departments are also preparing for the necessity of “revaccination,” Dr. Nirav Shah, president of the Association of State and Territorial Health Officials and Maine’s top health official, told reporters on Wednesday.
“It may be just a bit too early to tell with finality whether second doses, booster doses” will be needed in the fall, Dr. Shah said. “Certainly the better job we do now lowers the likelihood that variants could run loose.”
He added, “There is a direct link between what we do now and what we may need to do later.”
As of Wednesday, about 65 percent of U.S. adults had received at least one shot, according to federal data. But with vaccination rates slowing down, the administration is still focused on trying to meet President Biden’s goal of having at least 70 percent of adults get one shot by July 4, and also on addressing the global vaccine shortage.
“With the concerning Delta variant growing and millions more Americans to vaccinate, we are focused on our urgent and robust response to the pandemic,” Kevin Munoz, a White House spokesman, said in a statement Tuesday.
Last week, at the outset of his meeting with leaders of the Group of 7 nations, Mr. Biden announced that the United States would buy 500 million doses of Pfizer vaccine and donate them for use by about 100 low- and middle-income countries over the next year, describing it as America’s “humanitarian obligation to save as many lives as we can.”
One of the officials said Wednesday that if the Moderna purchase left the administration with surplus vaccine, the administration would donate those doses to other countries.
After leading the Phoenix Suns into the Western Conference finals, Chris Paul is in danger of missing at least part of the series after entering the N.B.A.’s coronavirus health and safety protocols.
How soon Paul can return to the Suns was not immediately known. The Suns announced Wednesday that Paul was “currently out” because of the protocols and that they would next provide an update about his status on Saturday.
Among the factors that will determine how long Paul, 36, will be away from the Suns are his vaccination status and whether he tested positive for the coronavirus. Players who test positive are typically placed in isolation for 10 to 14 days, but isolation time, depending on the circumstances, can be reduced if a player is vaccinated.
The team did not say why Paul was in the protocol. It could mean that he tested positive, but it also could just indicate that he was in close contact with someone who had. The N.B.A. announced Wednesday afternoon that one player had tested positive for the virus within the past week but, as is the usual practice, did not name the player. It’s not clear whether Paul has been vaccinated.
The prospect of Phoenix’s losing Paul after landing a spot in the conference finals on Sunday by completing a four-game sweep of the Denver Nuggets, was the latest blow to an N.B.A. postseason rocked by a string of health-related absences for star players.
Record profits warranted record bonuses. That was the recommendation in January by executives at the biotech firm Emergent BioSolutions. The board of directors agreed, signing off on nearly $8 million in cash and stock awards for five company leaders.
The bonuses arrived this spring even as Congress was investigating the company’s production of Covid-19 vaccines in Baltimore, where manufacturing mistakes have rendered 75 million doses unusable and forced a two-month-long shutdown of operations.
Emergent has nonetheless enjoyed the best financial year in its two-decade history, thanks largely to the government, for its largess and its decision to sidestep competitive bidding and other typical processes, according to interviews and previously undisclosed documents.
The lucrative agreement with Emergent reflects the early chaotic days of the pandemic, when the Trump administration was engaged in what one government official called “panic buying” with little outside scrutiny.
Emergent was in a good position to benefit. A review of the company’s filings with the Securities and Exchange Commission shows that its entire contract manufacturing business had never brought in anything close to the amount the federal government paid in 2020. Those payments exceeded the revenue the company had earned from all of its contract manufacturing in the previous three years combined.
RIO DE JANEIRO — The World Health Organization is urging the wealthy nations that recently pledged to donate one billion Covid-19 vaccine doses to give priority to Latin American nations with high levels of virus transmission and mortality.
Nine of the ten countries with the most recent deaths in proportion to their populations are in South America or the Caribbean, where vaccination campaigns are mostly off to slow and chaotic starts.
Health care professionals in the region are reporting a surge of younger patients requiring hospitalization, and in several cities, intensive care units are full or nearly so, according to Dr. Carissa F. Etianne, director of the Pan American Health Organization, a part of the W.H.O.
About 1.1 million new coronavirus cases and more than 31,000 deaths were reported last week in the Americas, most of them in South American nations where transmission remains out of control.
Colombia set new records for reported deaths three days in a row this week, peaking on Tuesday with 599 deaths. Brazil is on track to reach the grim milestone of 500,000 total deaths in the next week or two, and is reporting more than 70,000 new cases a day on average. Though Chile has carried out one of the world’s most aggressive inoculation campaigns, it has not yet managed to rein in transmission.
Dr. Etianne urged leaders of the major industrial democracies to use epidemiological criteria to determine which countries will be first in line to receive the one billion vaccine doses that the Biden administration and allied nations pledged to distribute.
“While vaccines are needed everywhere, we hope G7 nations will prioritize doses for countries at greatest risk, especially those in Latin America that have not yet had access to enough vaccines to even protect the most vulnerable,” she said.
W.H.O. officials said that focusing on the countries where the crisis is worst — including Colombia, Brazil, Argentina and Chile — made sense from both a moral and a pragmatic standpoint. Large sustained outbreaks in those countries raise the potential for more dangerous virus variants to emerge and to cross borders.
“No region of the world is protected from new peaks of transmission,” said Dr. Sylvain Aldighieri, the Covid-19 incident manager at the Pan American Health Organization. “No country and no region will be safe until high vaccination coverage is reached.”
Japan’s leaders are racing to lift Covid-19 vaccination rates at home, but that hasn’t stopped them from donating doses in the Asia Pacific region as part of a wider geopolitical strategy.
Foreign Minister Toshimitsu Motegi of Japan said this week that the country would send a million doses of the AstraZeneca vaccine to Vietnam on Wednesday. The shots are among the 120 million doses that Japan expects to obtain as part of a deal it struck with the British-Swedish manufacturer.
Japan also donated more than a million AstraZeneca shots to Taiwan this month, and Mr. Motegi said this week that it planned to donate vaccines to Indonesia, Malaysia, the Philippines and Thailand.
Japan is donating vaccines to Taiwan and Vietnam directly rather than through Covax, the global vaccine-sharing program. That suggests geopolitics are a motivating factor, experts say.
China has been promoting its self-made vaccines in Southeast Asia and beyond in a charm offensive that has clear diplomatic overtones. Stephen Nagy, a political scientist at International Christian University in Tokyo, said that Japan appeared to see its own vaccine diplomacy as a counterweight.
“Watching what China has done, delivering a lot of Sinovac in particular countries, Japan does not want to fall behind,” he said, referring to the manufacturer of one of China’s main vaccines.
China has been asserting its geopolitical muscle in the region for years, flying warplanes over Taiwan and fortifying artificial islands in parts of the South China Sea that are also claimed by Malaysia, the Philippines and Vietnam. Japan has often found ways to gently push back.
In Vietnam, Japan has invested in large infrastructure projects and supplied the country’s navy with coast guard vessels for patrolling the South China Sea. After Prime Minister Yoshihide Suga of Japan took office last year, he made Vietnam his first overseas stop.
Vietnam could use more vaccines. It kept infections low until recently through rigorous quarantining and contact tracing, but is now experiencing its worst outbreak yet. Only about 1.5 percent of the country’s 97 million people have received even one shot, according to a New York Times tracker.
Japan’s health authorities have authorized the AstraZeneca vaccine for emergency use, and about 90 million of its 120 million doses will be manufactured domestically. But the government has held off administering that vaccine locally because of concerns over very rare complications involving blood clots.
Japan’s inoculation campaign has also been held up by strict rules that allow only doctors and nurses to administer shots, and by a requirement that vaccines be tested on people in Japan before being approved for use.
Only about 25 million vaccine doses have been administered in Japan and 15 percent of the population has received at least one shot. That percentage is about the same as in India, and far below that of most richer countries.
The government wants to speed up vaccines in part so that it can allow domestic spectators when the Tokyo Olympics begin in July. The news agency Kyodo reported on Tuesday that officials are considering allowing up to 10,000 fans or half of a venue’s capacity — whichever is smaller — at Olympic events.
For now, Tokyo and nine other prefectures remain under a state of emergency that has been in effect since late April. The order is scheduled to expire on June 20, barely a month before the Olympics start.
In the United States, fireworks lit up the night sky in New York City on Tuesday, a celebration meant to demonstrate the end of coronavirus restrictions. California, the most populous state, has fully opened its economy. And President Biden said there would be a gathering at the White House on July 4, marking what America hopes will be freedom from the pandemic.
Yet on Wednesday the country’s death toll passed 600,000 — a staggering loss of life.
In Russia, officials frequently say that the country has handled the coronavirus crisis better than the West and that there have been no large-scale lockdowns since last summer.
But in the week that President Vladimir V. Putin met with Mr. Biden for a one-day summit, Russia has been gripped by a vicious new wave of Covid-19. Hours before the start of the summit on Wednesday, the city of Moscow announced that it would be mandating coronavirus vaccinations for workers in service and other industries.
“We simply must do all we can to carry out mass vaccination in the shortest possible time period and stop this terrible disease,” Sergey S. Sobyanin, the mayor of Moscow, said in a blog post. “We must stop the dying of thousands of people.”
It was a reversal from prior comments from Mr. Putin, who said on May 26 that “mandatory vaccination would be impractical and should not be done.”
Mr. Putin said on Saturday that 18 million people had been inoculated in the country — less than 13 percent of the population, even though Russia’s Sputnik V shots have been widely available for months.
The country’s official death toll is nearly 125,000, according to Our World in Data, and experts have said that such figures probably vastly underestimate the true tally.
While the robust United States vaccination campaign has sped the nation’s recovery, the virus has repeatedly confounded expectations. The inoculation campaign has also slowed in recent weeks.
Unlike many of the issues raised at Wednesday’s summit, and despite the scientific achievement that safe and effective vaccines represent, the virus follows its own logic — mutating and evolving — and continues to pose new and unexpected challenges for both leaders and the world at large.
A fierce debate has erupted in Italy after the government halted use of the AstraZeneca coronavirus vaccine in people under 60 and said that people in that age group who had already received a first dose of that vaccine would get a different shot for their second.
“A mix for cocktails is one thing,” Matteo Salvini, the leader of the nationalist League party, which is part of the government, told reporters on Tuesday as he asked for clear and consistent directions, “A mix of vaccines is a different one.”
The announcement last week was the latest in a series of policy lurches surrounding the AstraZeneca vaccine that have left many Italians confused and angry.
As reports circulated that an 18-year-old girl who received the vaccine had died after having been hospitalized with a thrombosis, the government said it had reassessed the vaccine, and had concluded that because the spread of the virus had slowed markedly in Italy, the benefits of using the vaccine in people under 60 no longer outweighed the risks.
Other countries have also looked at mix-and-match approaches to second doses, especially after safety concerns arose over the AstraZeneca vaccine’s apparent association with some deaths from the rare blood-clotting condition. In France, about 500,000 people became eligible for a different booster dose in April after the government halted use of the AstraZeneca vaccine in people under 55.
Trials are underway around the world to test the mix-and-match approach, referred to by scientists as heterologous prime-boost. Citing data from two clinical trials in Spain and one in Britain, the Italian drug regulatory agency said the approach was safe and effective.
Still, the idea is meeting with opposition in Italy, where almost a million people aged 18 to 59 who have had first doses of AstraZeneca’s vaccine would be affected.
“We are not going to administer vaccines different from the first dose,” Vincenzo De Luca, the president of Campania, the southern Italian region that includes Naples, said in a statement on Sunday. “The current level of confusion risks jeopardizing the very continuation of the vaccination campaign.”
(Mr. De Luca later said his region would comply with the government’s policy, but maintained that there was “communication chaos” around vaccines.)
Public health researchers also raised questions about what they called “creative vaccination.”
“Scientific evidence today on this topic is still preliminary and keeps a certain level of insecurity,” Nino Cartabellotta, the president of GIMBE, a research foundation, said on Italian radio.
Others were more blunt in criticizing the government’s shifting vaccine policies. “We do not understand anything anymore,” Luca Pani, a former director of Italy’s drug regulatory agency, wrote in the Italian newspaper Il Foglio, “besides the fact that, putting one patch above the other, they turned the AstraZeneca saga into a monster.”
The top health care official for the Lazio region, which includes Rome, said that since the policy was announced, about 10 percent of affected people in his area were skipping or canceling their second-dose appointments or were walking out without receiving a shot when told that it would be of a different vaccine. He said the government should allow people to decide for themselves whether to stick with AstraZeneca for their second shot.
Constant Méheut contributed reporting from Paris.