Nearly a year ago, more than 43 percent of coronavirus deaths in the United States were tied to long-term-care facilities. Now, the deaths of people connected to such facilities has dropped to 31 percent, according to a New York Times database, revealing an improving picture for the oldest Americans.
Throughout the pandemic, The Times has tracked Covid-19 cases and deaths in nursing homes, assisted-living centers, memory care units and other long-term facilities for older people, and has identified more than 1.38 million infections among residents and employees of the facilities, as well as more than 184,000 deaths. The virus has spread easily in these facilities, and has been particularly lethal for unvaccinated adults in their 60s or older.
“Coronavirus highlighted some of the needs of both the residents themselves and the facilities,” said Cindy Prins, an epidemiologist at the University of Florida, citing a need for more oversight, greater examination of infection controls and better training for staff members.
She said the pandemic had also forced many people to re-evaluate their views on long-term care.
“I’m sure there are people who are feeling like, ‘Could I have cared for them at home? Could I have a different outcome?’” Dr. Prins said.
Since vaccines have arrived, deaths in nursing homes, in particular, have fallen significantly. According to the federal Centers for Medicare and Medicaid Services, nursing homes across the United States reported more than 5,000 deaths per week from early December through mid-January. Since late March, the homes have reported fewer than 300 deaths a week.
Still, deaths slowly continue to mount. Though health care workers were among the first group to become eligible for inoculation, vaccination hesitancy has remained a challenge at long-term care facilities.
With reports of infections occurring among vaccinated people in long-term-care facilities in Chicago and Kentucky, the Centers for Disease Control and Prevention have stressed that inoculating workers and residents is essential to preventing further spread of the virus.
The federal government is requiring nursing homes to report the vaccination status of their residents and staff members in order to examine the impact of the vaccines. More than 4.9 million residents and employees in long-term-care facilities have received at least one dose of a Covid-19 vaccine through a federal program, according to the C.D.C. Others have been vaccinated through state and local efforts.
“Reporting vaccination rates is critical to facilitating in-person visitations in nursing homes,” said Dr. David Gifford, the chief medical officer for the American Health Care Association and National Center for Assisted Living, a trade group that represents more than 14,000 U.S. nursing homes and long-term care facilities.
He added: “It is important that we not judge facilities with low vaccination rates but instead seek to understand whether additional resources or outreach can be done to encourage more staff and residents to get the vaccine, or help facilities acquire additional vaccines for new patients and hires.”
Brillian Bao and
Financial support for Covid-19 vaccination efforts in lower-income nations received a $2.4 billion lift on Wednesday when world leaders met at a virtual summit hosted by the Japanese government and Gavi, the Vaccine Alliance.
The funds were pledged by wealthier countries, foundations and private companies. Five countries — Belgium, Denmark, Japan, Spain and Sweden — also announced plans to share a total of 54 million doses from their domestic supplies with countries in need.
The support is primarily designated for Covax, a year-old initiative promoting equity in the distribution of Covid-19 vaccines. It has shipped more than 77 million doses to 127 countries and is led by Gavi, the World Health Organization and the Coalition for Epidemic Preparedness Innovations.
The funds were sought to buy additional vaccine doses for the countries least able to afford them and to invest in new vaccine candidates. “Ability to pay should not determine whether someone is protected from this virus,” said Dr. Seth Berkley, the chief executive of Gavi.
To date only 0.4 percent of all Covid-19 vaccine doses have been administered in low-income countries, according to the World Health Organization’s director-general, Tedros Adhanom Ghebreyesus, who spoke at the meeting. In many countries, even the most vulnerable adults and health care workers have not received vaccinations.
Dr. Berkley said that on average, wealthy countries had vaccinated more than a third of their populations, whereas low income countries had vaccinated less than 1 percent.
How quickly wealthier countries deliver on their promises to share doses remains to be seen; most previously announced gifts have yet to be delivered.
The largest new financial pledge, $800 million, came from Japan, which also said it would eventually share 30 million doses of locally produced vaccines. To date, it has administered only about 14 million shots to its own population.
The United States previously announced $2 billion in support for Covax, and Vice President Kamala Harris spoke at the summit meeting but did not address ongoing calls for the United States to move more quickly to share its vaccine supply, especially as its vaccination rates increase and cases of Covid-19 fall sharply.
“Our collective future depends on the collective response to the global crisis,” Ms. Harris said. “The challenge before us is to provide equal access.”
She added: “People are still contracting Covid-19. People are still dying every day. And that is why we must work together to get people vaccinated as quickly as possible in every nation throughout the world.”
New pledges came from countries including Australia, France, Kuwait, Mauritius, Mexico, Switzerland and Vietnam. The Bill & Melinda Gates Foundation, Mastercard and the Visa Foundation were among institutions committing funds, and the European Investment Bank announced additional financing to support cost-sharing with African Union countries.
As of Wednesday, $9.6 billion had been raised for Covax’s Advance Market Commitment, a financing mechanism to secure vaccines for low- and middle-income economies
As India’s Covid-19 vaccination drive falters, the country’s Supreme Court has demanded that Prime Minister Narendra Modi’s government explain how it plans to meet its target of inoculating about 900 million adults by the end of the year.
As India struggles with a second wave of the virus that is killing some 3,000 people a day, according to official statistics, Mr. Modi’s administration is already woefully behind in its goal of administering 400 million to 500 million shots by July.
So far, India has administered about 220 million doses, and just 45 million people — about 4 percent of the population — are fully vaccinated with two doses. Vaccinating all adults would require at least another 1.5 billion doses.
The Supreme Court stepped in this week, signing an order on Monday that demanded that the government explain how it would obtain vaccines given stretched global supplies; what purchase orders it has placed; and how officials planned to resolve a messy dispute between states and the central government over vaccine procurement. The fight ensued after Mr. Modi declared in mid-April that states would need to purchase most doses on their own, which the government said would help speed up vaccination efforts but instead sowed confusion.
States have been forced to compete for limited supplies made two main domestic vaccine manufacturers, the Serum Institute of India, which produces the vaccine developed by Oxford University and AstraZeneca, and Bharat Biotech, which makes a vaccine called Covaxin. Officials in several states have complained that they have been unable to acquire doses directly from suppliers, which insist on dealing with the central government.
The court criticized Mr. Modi’s policy, arguing that the central government would have enjoyed greater bargaining power as a single, wholesale buyer. It also slammed the government for allowing private health facilities to charge people under 45 for vaccinations, calling the policy “arbitrary and irrational.”
To step up its campaign, Mr. Modi’s government is banking on significant expansions of production by the Serum Institute and Bharat Biotech. While Bharat Biotech’s capacity started out relatively modest, the Serum Institute — a giant in vaccine manufacturing — has fallen short of its ambitions to produce more and faster. Serum’s failures have reverberated beyond India; the company has halted supplies to Covax, a global vaccine facility, derailing vaccination efforts in many poorer countries.
India has been racing to find vaccines from other sources. Russia’s Sputnik V vaccine has begun to be used in some parts of the country, with one supplier expecting at least 36 million doses in the next couple of months. This week, the Indian government signed a deal with a domestic company called Biological E. Limited for 300 million doses of its vaccine, which is undergoing clinical trials and has yet to receive regulatory approval.
India’s daily infections have fallen by more than half from a month ago, when it was recording more than 400,000 cases a day. But experts warn that the official statistics are an undercount, and that as the virus spreads into rural areas with limited health infrastructure, the true extent of its toll is unclear.
Early in the pandemic, as hospitals in New York began postponing operations to make way for the flood of Covid-19 cases, Dr. Tomoaki Kato continued to perform surgery. Patients still needed liver transplants, and some were too sick to wait.
At 56, Dr. Kato was healthy and exceptionally fit. He had run the New York City Marathon seven times, and he specialized in operations that were also marathons, some lasting 20 hours. He was renowned for surgical innovations, deft hands and sheer stamina. At NewYork-Presbyterian/Columbia University Irving Medical Center, his boss has called him “our Michael Jordan.”
Dr. Kato became ill with Covid-19 in March 2020, and was soon one of the sickest patients in his own hospital. He came close to death “many, many times,” according to Dr. Marcus R. Pereira, who oversaw Dr. Kato’s care and is the medical director of the center’s infectious disease program for transplant recipients.
When the worst had passed, colleagues feared that he might never be able to perform surgery again. But Dr. Kato emerged from two months in the hospital with a determination to get back to work and a new sense of urgency about the need to teach other surgeons the innovations he had developed. His illness also enabled him to connect with patients in new ways.
“I really never understood well enough how patients feel,” he said. Despite telling patients, “‘Even though it looks like hell now, it will get better and you’ll get through it,’” he said, “I really never understood what that hell means.”
Facing vaccine shortages, Canada’s immunization advisory body is recommending that some Canadians follow up their AstraZeneca shots with a different vaccine on the second dose.
The National Advisory Committee on Immunization said on Tuesday that people who had received a first dose of the AstraZeneca vaccine could be given either the Pfizer-BioNTech or Moderna vaccines as their second dose. It also said that the Pfizer and Moderna vaccines could be used interchangeably, although it recommended sticking with a single brand when possible.
While Canada’s health care system has generally been efficient in dispensing shots, no vaccines are manufactured in the country and larger shipments did not begin arriving until the past several weeks. To ensure that the maximum number of Canadians have some protection, Canada focused on getting at least one dose to as many people as possible. While 62 percent of Canadian adults have been given at least one shot, only 5.7 percent are fully vaccinated.
The advisory panel’s recommendation came as many provinces are starting to ramp up second doses, and it may resolve a potential headache.
Most of the increased shipments of vaccine have come from Pfizer, while supplies of the Moderna and AstraZeneca vaccines have been in much shorter supply. To date, 19.3 million doses of Pfizer’s vaccine have come to Canada, compared with 5.7 million doses of Moderna and 2.8 million Astra Zeneca shots.
The ability to substitute Pfizer’s vaccine for second doses eliminates concerns about limited supplies.
The advisory panel said that its recommendation followed similar advice from Denmark, Finland, France, Germany, Norway, Spain and Sweden. Several studies have shown that mixing vaccines is safe and effective, the committee said.
Seven of Canada’s 10 provinces, whose health care systems perform the vaccinations, have said they will allow people to change course between doses.
About 10,000 of the 80,000 volunteers who had stepped forward to help with next month’s Tokyo Olympics have quit, the chief executive of the Games’ organizing committee said on Wednesday, amid rising worries about holding the event during the pandemic.
The chief executive, Toshiro Muto, told reporters that there was “no doubt” that volunteers were worried about becoming infected with the coronavirus, while some who quit cited personal reasons. About 1,000 volunteers withdrew in late February after Yoshiro Mori, who was then the organizing committee’s chairman, said that “Women talk too much in meetings.”
Mr. Muto said that there were still enough volunteers to assist with the Olympics and Paralympics, and that operations for both events would not be affected, since they have been streamlined.
Katsunobu Kato, the chief cabinet secretary, confirmed Mr. Muto’s announcement on Thursday.
“I expect the organizing committee to take through anti infection measures for volunteers,” Mr. Kato said, “and they need to respond carefully to volunteers as well as Japanese people in regards to concrete infection prevention measures.”
The withdrawals were another indication of the Japanese public’s opposition to these Olympics, which were rescheduled from last year because of the pandemic. A recent poll found that more than 80 percent of people in Japan did not want Tokyo to host the Games.
Tokyo and other parts of the country are under a state of emergency as Japan battles a fourth wave of the coronavirus. Less than 3 percent of the population has been fully vaccinated, one of the lowest rates among industrialized nations, and many Japanese people believe that the Olympics have become a distraction.
The United States is roughly on track to meet President Biden’s goal of getting every adult at least one shot of a Covid-19 vaccine by July 4 if the current vaccination pace holds. But much of the country has seen a significant slowdown in recent weeks, and the positive national trend hides deeply uneven progress among the states.
A handful of states are unlikely to reach 70 percent of their adult residents before the end of the year.
“You reach a certain rate nationally, which looks excellent and would really suggest that you are in a place to reduce the likelihood of infectious spread, but that can be misleading,” said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, which represents state health agencies.
“You still have these significant pockets and states where the rates of immunity are much lower,” he added. “So we could have another wave pop up.”
In many states in the Deep South and Mountain West, vaccinations have leveled off because of limited access and shot hesitancy.
Alabama, Louisiana, Mississippi and Wyoming have vaccinated fewer than half of their adult residents, and projections show that they are unlikely to reach much more than half by early July.
For more than 20 years, the husband and wife were stalwarts of their evangelical community in southern Vietnam: pastors of a small Protestant church where they distributed food and clothing to the needy of Ho Chi Minh City.
Now, the couple are pariahs. They have been blamed by the authorities for a major coronavirus outbreak, are facing a criminal investigation and have been held accountable on social media for a lockdown in their neighborhood and a ban on religious services nationwide.
The couple, Phuong Van Tan and Vo Xuan Loan, who are hospitalized with Covid-19, are accused of allowing parishioners to pray together without wearing masks, a violation of coronavirus protocols that officials say resulted in an outbreak in May linked to more than 200 cases.
Health officials believe that the outbreak started with Ms. Loan, who traveled to Hanoi, the capital, in late April and began experiencing symptoms about two weeks later. They contend that churchgoers gathered in close quarters for their services, did not wear masks and did not report their illnesses.
“These days, in our hospital beds, we grieve both physically and mentally about what is going on,” Mr. Tan, 60, wrote in a Facebook post, in which he asked for forgiveness. “On behalf of the entire church, my wife and I, as pastors, would like to sincerely apologize to all the community.”
Ms. Loan, 65, contradicted the official account of her illness. She believes that she contracted the virus after returning from Hanoi and was not the source of the cluster. She also denied that parishioners had gathered without wearing masks.
“I am the one who always asked people from my church to wear a mask,” she said by phone from the Hospital for Tropical Diseases in Ho Chi Minh City, where she is being treated. “I brought masks to all the people of the church and to people in the community.”
Vietnam kept the coronavirus at bay for more than a year. But the church cluster, outbreaks at factories in the country’s north and the emergence of a troubling new variant all suggest that the country’s luck might be running out as the virus resurges in parts of Southeast Asia. More than half of Vietnam’s 7,800 cases have occurred in the past month.
New York City, with the nation’s largest school district, is hoping to increase vaccination rates among children age 12 to 17 before they close their books and head out for the summer on June 25.
“We want to make schools a place where kids can get vaccinated,” Mayor Bill de Blasio said in announcing the plan Wednesday during a news conference at City Hall. Later, he added, “We’re going to get the most done we can between now and the end of school later this month.”
Details of the initiative were not immediately announced, but Mr. de Blasio said the program would start on Friday with mobile vaccination vehicles at four schools in the Bronx.
According to city data, the Bronx has the lowest rate of fully vaccinated residents, with 35 percent, below the citywide rate of 44 percent. (Brooklyn has 38 percent, Staten Island 41 percent, Queens 48 percent and Manhattan 55 percent.)
This data echoes what officials have seen nationwide suggesting that vaccines have been given disproportionately in areas with wealthy and white residents, even though the pandemic hit low-income communities of color the hardest.
The program is being conducted in collaboration with the city’s education and health departments, as well as the teacher’s union, the mayor said.
Offering vaccines at middle schools is part of a national shift away from large vaccination facilities used earlier in the pandemic. Health officials are now relying on smaller, more community-based sites, which may be more trusted and accessible to those who have not yet been vaccinated.
Younger people were among the most recent group to become eligible for the vaccine. The Food and Drug Administration authorized vaccines for people as young as 16 in December, and children aged 12 through 15 became eligible last month. This led to an immediate bump in the nation’s vaccination rates, but, as with other groups, that initial burst faded somewhat over time.
Having mobile vaccination clinics at schools, Mr. de Blasio said, “is going to help reach more and more young people and continue to keep New York City ahead of the national average for youth vaccination.”