LONDON — Dominic Cummings, the former top aide to Prime Minister Boris Johnson of Britain, on Wednesday painted a picture of chaos, incompetence and confusion at the heart of the government in a ferociously critical account of its early handling of the Covid-19 pandemic.
Testifying before lawmakers, Mr. Cummings said that Mr. Johnson had initially regarded Covid-19 as a “scare story” and at one point had suggested that a doctor inject him with the coronavirus on live television to play down the dangers to a worried public.
The prime minister was being advised by a health secretary, Matt Hancock, whom Mr. Cummings accused in his testimony of lying repeatedly, being unworthy of the health care workers he directed and presiding over the deadly transfer of elderly patients from hospitals to nursing homes, many of them carrying the virus.
And as the pandemic closed in on Britain, Mr. Johnson was distracted, his former aide said, by an unflattering story about his fiancée and her dog.
“When the public needed us most, the government failed,” said Mr. Cummings, the political strategist who masterminded Britain’s campaign to leave the European Union and engineered Mr. Johnson’s rise to power before falling out bitterly with his boss and emerging as a self-styled whistle-blower.
Mr. Cummings testified for more than seven hours, in a scene with few precedents in British politics: an unelected aide who had been arguably the nation’s second-most powerful man, offering an unfiltered look at the inner workings of the British government as it confronted the greatest national emergency since World War II.
“The problem in this crisis was very much lions led by donkeys, over and over again,” Mr. Cummings said.
Mr. Johnson, who was hospitalized with a severe case of Covid-19 in April 2020, flatly rejected several of the assertions of his former aide in his own appearance on Wednesday in Parliament, where lawmakers are trying to determine how the early days of the pandemic were botched so badly.
Mr. Cummings, 49, did not absolve himself of all blame. He admitted he had not been open about the reasons for a much-criticized road trip he made with his family that breached lockdown rules. And he acknowledged his mistake in not pushing the prime minister to lock down the country earlier than he did, in March of last year.
“Yes, it was a huge failing of mine,” Mr. Cummings told a joint meeting of Parliament’s Science and Technology Committee and Health and Social Care Committees. “I bitterly regret that I did not hit the emergency panic button earlier than I did.”
The Food and Drug Administration on Wednesday authorized a monoclonal antibody drug developed by GlaxoSmithKline and Vir as the third treatment of its kind cleared to help keep high-risk Covid patients out of the hospital.
In laboratory tests the newly authorized drug, known as sotrovimab, has been able to neutralize the virus variants first identified in Britain, South Africa, Brazil, California, New York and India. The federal government, which has so far purchased the other antibody treatments given to Covid patients in the United States, has not announced any plans to purchase the new drug.
GSK has been in conversations with the United States government and is “working through existing commercial channels to make sotrovimab available to patients and health systems in need,” said Kathleen Quinn, a company spokeswoman.
The company said in a news release that it expects the drug to become available in the U.S. “in the coming weeks.”
The new treatment may offer an advantage as concerns rise about new virus variants that may evade some antibody drugs.
The federal government has paused shipments of one antibody treatment on the market, a cocktail of two drugs from Eli Lilly, to eight states because of the high prevalence there of the variants first seen in South Africa and Brazil. Lab experiments suggest those variants can resist Lilly’s treatment. (The other available antibody treatment, a cocktail of two drugs from Regeneron, appears to neutralize the array of variants, based on lab tests.)
GSK and Vir’s treatment is a single drug, designed to mimic the antibodies generated naturally when the immune system fights off the coronavirus, like those detectable after someone infected with it recovers. Its authorization was based on a study of 583 volunteers who had started experiencing symptoms within the previous five days. The study found that those who got the GSK-Vir treatment showed an 85 percent reduction in their risk of hospitalization or death, compared with those who got a placebo.
Even as vaccination numbers rise and infection rates fall in the United States, the antibody treatments are likely to remain an important tool for preventing bad outcomes in high-risk patients, doctors say. Thousands of people in the United States are still testing positive, and hundreds dying, each day.
Last week the F.D.A. broadened the criteria that doctors can use to determine eligibility for the treatment, opening the door for more young people with certain medical conditions like hypertension, and members of racial or ethnic groups considered to be at higher risk than others for bad medical outcomes.
“Ultimately, it gives prescribers a lot of latitude in what they can give this for,” said Dr. Walid F. Gellad, who directs the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.
But the drugs from Lilly and Regeneron have not been used as widely as expected for a range of reasons, according to public health experts.
The antibody drugs are all cumbersome to administer. Patients often don’t know to ask for them or where to find them. And many doctors were skeptical of the evidence supporting the treatments when they first became available last November, though that has changed as more clinical trials have reported impressive results.
“There’s still a role for these,” Dr. Gellad said. “The problem is just people aren’t getting them who could benefit from them, and having another one on the market doesn’t necessarily solve that.”
GSK and Vir’s treatment, like the other antibody drugs, must be administered via intravenous infusion by a health-care provider, which will make it harder to access. The drug makers are testing a formulation injected intramuscularly, like a vaccine, but that is not expected to be available soon.
The coronavirus is now spreading faster in Manitoba than in any other province or state in Canada, the United States or Mexico, with Indigenous people and people of color hit disproportionately hard.
Figures released on Wednesday show that over the last two weeks, the prairie province in the middle of Canada reported an average of 35 new cases a day per 100,000 population. Canada as a whole is averaging about 10 a day per 100,000; the United States, 7 per 100,000; and Mexico, 2 per 100,000. The next highest states or provinces are Alberta at 16 and Colorado at 15.
Dr. Marcia Anderson, the public health lead of the Manitoba First Nation Pandemic Response Coordination Team, told reporters on Wednesday that from the beginning of the month until May 19, Indigenous people and other nonwhite people accounted for 61 percent of cases in Manitoba, even though they make up 37 percent of the province’s population.
People of Southeast Asian descent are the most disproportionately affected, with a rate of 146 per 1,000 people, 13 times the rate among white people.
The surge in Covid-19 cases has overwhelmed intensive care units in Manitoba’s hospitals, forcing some patients to be evacuated by air to other provinces. Eighteen patients have been flown to neighboring Ontario, including some to Ottawa, about 1,000 miles away. Saskatchewan, the province to the west, was expected to receive an evacuated patient from Manitoba on Wednesday.
On Tuesday, a group of doctors called on the province to follow the lead of Ontario and others by introducing a stay-at-home order and closing nonessential businesses. Those steps have allowed other provinces to rein in their most recent waves of infections.
Stores in Manitoba have been limited to 10 percent of capacity, and gyms and hair salons have been closed for several weeks. On Tuesday, the province’s premier, Brian Pallister, extended limits on outdoor gatherings that were put in place for last weekend; they now last until the end of this week.
Mr. Pallister suggested on Tuesday that the worsening situation in the province was being caused not by too few restrictions but rather by people failing to comply with the restrictions that are already in force.
“I don’t have a lot of sympathy left for people who disobey public health orders knowingly and willingly,” he said.
When the leader of the United Nations more than a year ago implored armed combatants to pause their fighting so the world could focus on battling the coronavirus, he warned that “the worst has yet to come” in the disease’s rampage, especially through conflict zones.
That forecast in April of 2020 by Secretary General António Guterres proved not only correct — it may also have been an understatement.
“In many countries, conflict has made it more difficult to control the spread of the virus and care for infected people,” Mark Lowcock, the top U.N. relief official, told the Security Council on Tuesday as it met to discuss the protection of civilians in armed conflicts.
Not only did the antagonists in the chronic conflicts of Syria, Yemen, South Sudan, Afghanistan and eastern Ukraine ignore the plea to put down their weapons, but new or renewed fights erupted — between Azerbaijan and Armenia last September, within Ethiopia in November, within Myanmar in February, and most recently between the Israeli military and Hamas in Gaza.
Many of these conflicts were a major contributor to the surge last year in the number of forcibly displaced people, which reached a total of at least 80 million, Mr. Lowcock said, while “insecurity, sanctions, counterterrorism measures and administrative hurdles hindered humanitarian operations.”
The 11-day war that was halted last week between the Israeli military and Hamas, the militant group that controls Gaza, provided a textbook example of how the coronavirus could prosper in a conflict zone.
Gaza, a densely crowded coastal strip that is home to two million people, had already been suffering a severe outbreak of Covid-19 infections before the conflict erupted.
Then Israeli bombings destroyed Gaza’s only coronavirus testing facility and forced thousands of unvaccinated Gazans into U.N. schools that became bomb shelters, with no social distancing.
Matthias Schmale, the top U.N. Palestinian relief official in Gaza, said he feared those schools had become “mass spreaders,” which could deepen the disease’s grip on Gaza — weeks after the hostilities ceased.
President Biden on Wednesday ordered U.S. intelligence agencies to investigate the origins of the coronavirus, indicating publicly that his administration takes seriously the possibility that it was accidentally leaked from a lab, as well as the prevailing theory that it was transmitted to humans by an animal.
In a statement, Mr. Biden made clear that the agencies had not reached consensus on how the virus originated. But he directed them to “redouble their efforts” and report back in 90 days.
The president’s statement, his most public and expansive yet on the uncertainty about how the virus spread, came as top health officials renewed their appeals this week for a more rigorous investigation. There is also mounting criticism of an earlier report by an international team of experts accused of dismissing the possibility that the virus accidentally escaped from a Chinese laboratory.
In the past several days, the White House had downplayed the need for an investigation led by the United States and insisted that the World Health Organization was the proper place for an international inquiry. Mr. Biden’s statement was an abrupt shift, though officials declined to be specific about the shift.
“What has changed is, he wants to give another 90 days to dig a little deeper, to double down — the I.C. to double down their efforts,” said Karine Jean-Pierre, the deputy White House press secretary, referring to the intelligence community. “The W.H.O. doing their thing and the I.C. doing what they’re doing currently is not mutually exclusive.”
But Mr. Biden’s comments suggested that his government’s review of the evidence made it that much more urgent for American investigators to take the lead. In his statement, the president said he had asked his national security adviser in March to instruct intelligence officials to report on their latest analysis of the virus’s origins.
Mr. Biden said he had received their report this month before asking for “additional follow-up.” The intelligence community had “coalesced around two likely scenarios,” he said, but they had not definitively answered the question.
“Here is their current position: ‘While two elements in the I.C. leans toward the former scenario and one leans more toward the latter — each with low or moderate confidence — the majority of elements do not believe there is sufficient information to assess one to be more likely than the other,’” Mr. Biden said.
The calls from the president and other top American health officials were the latest in a series of White House demands in recent months that any such inquiry be free from Chinese interference. But they drew additional attention as some scientists expressed a new openness to the idea of a lab accident and the W.H.O. grappled with how to respond.
A joint W.H.O.-China inquiry, whose findings were released in March, dismissed as “extremely unlikely” the possibility that the virus had emerged accidentally from a laboratory.
Those suggestions that the coronavirus may have been accidentally carried out of a laboratory in late 2019 in the Chinese city of Wuhan were largely drowned out last year by scientists’ accounts of its likely path from an animal host to humans in a natural setting.
Many scientists, including those who lead American health agencies, believe that a so-called spillover event remains the most plausible explanation for the pandemic. But the joint inquiry by the W.H.O. and China did not settle the matter: The Chinese government repeatedly tried to bend the investigation to its advantage, and Chinese scientists supplied all the research data used in the final report.
Dr. Francis Collins, the National Institutes of Health director, criticized the report while testifying to Senate lawmakers on Wednesday about the agency’s budget.
“It is most likely that this is a virus that arose naturally. But we cannot exclude the possibility of some kind of a lab accident,” he said. “That’s why we’ve advocated very strongly that W.H.O. needs to go back and try again after the first phase of their investigation really satisfied nobody.”
Immunity to the coronavirus lasts at least a year, possibly a lifetime, improving over time especially after vaccination, according to two new studies. The findings may help put to rest lingering fears that protection against the virus will be short-lived.
Together, the studies suggest that most people who have recovered from Covid-19 and who were later immunized will not need boosters. Vaccinated people who were never infected most likely will need the shots, however, as will a minority who were infected but did not produce a robust immune response.
Both reports looked at people who had been exposed to the coronavirus about a year earlier. Cells that retain a memory of the virus persist in the bone marrow and may churn out antibodies whenever needed, according to one of the studies, published on Monday in the journal Nature.
The other study, which is also under review for publication in Nature, found that these so-called memory B cells continue to mature and strengthen for at least 12 months after the initial infection.
After the state of Ohio announced with great fanfare that residents who got at least one shot of a coronavirus vaccine would be eligible to win a hefty $1 million, Jack Pepper saw something remarkable happen at his sleepy rural vaccination clinic.
For the first time in a while, there was a line at the door. Officials, who had been strategizing about how they might give away extra doses, were suddenly operating at full capacity.
“I think we did close to 400 people in four hours,” said Mr. Pepper, the administrator for the health department in Athens County, home to about 65,000 people in southeastern Ohio. “Anywhere I go, people are joking with me, ‘Hey, when am I going to win my million dollars?’”
Anticipation approached a peak as the Ohio lottery campaign — deemed “Vax-a-Million” (including a cheeky bandage on the X) — announced its first winner on television on Wednesday night. Abbigail Bugenske of Silverton, Ohio, near Cincinnati, won the initial $1 million prize.
It was among the first of several chances for Americans to win big money — if they have been vaccinated.
Colorado announced its own $1 million vaccine lottery this week, and Oregon is offering a $1 million jackpot, in addition to $10,000 prizes. Elsewhere, state and local officials are getting creative with simple approaches (free beer in Erie County, N.Y.) and fancy ones (dinner with the governor of New Jersey, anyone?).
Gov. Andrew M. Cuomo of New York on Wednesday added to the growing list of perks and incentives offered to those getting vaccinated against the coronavirus. He announced that any state resident between the ages of 12 and 17 who gets a first dose of the Pfizer-BioNTech vaccine starting on Thursday would be entered into a raffle to win a full-ride scholarship to a New York public university.
The incentive was designed to spur vaccinations among young people. Many younger people only became eligible recently, and the Pfizer vaccine was not made available to 12- to-15-year olds until earlier this month. Moderna said on Tuesday that its vaccine, which is authorized only for use in adults, was powerfully effective in 12- to 17-year-olds, and that it planned to apply for authorization in June.
Still, Mr. Cuomo said overall vaccinations in the state had declined considerably in recent weeks, and young people may feel that they have not been considered a priority age group for vaccination.
“It is an incentive for students,” he said. “You’re planning on going to college. You are wondering about how you’re going to pay for it.”
Parents of New York residents ages 12 to 17 who get vaccinated can choose to add their child to a pool of names. Every week for five weeks, state officials will randomly select 10 names for the scholarships, which cover tuition, room and board, books and transportation.
The estimated costs for a student living on campus at a State University of New York location, for example, are: $7,070 for tuition, $14,110 for room and board, $1,290 for books and supplies and $1,010 for transportation.
An existing state program, the Excelsior Scholarship, is designed to cover only tuition costs for some students whose families earn $125,000 or less per year, in combination with other financial aid programs.
State officials did not offer any other restrictions on eligibility for the raffle program on Wednesday.
The raffle is one of an array of incentives officials in New York are offering to people who get vaccinated. As of Wednesday, 55 percent of state residents have received at least one shot, and 44 percent are fully vaccinated, according to a New York Times database.
Those who get vaccinated at walk-in sites in some subway stations can get a free seven-day MetroCard. People who get a first shot at New York City-run sites can get free tickets to a Brooklyn Cyclones game or a free 10 ride pass on the New York City ferry system, among other incentives. The governor announced earlier this week that anyone getting vaccinated before May 31 can get a free two-day pass to any state park.
The U.S. pace of vaccinations has declined sharply since mid-April and President Biden has moved to shift the nation’s vaccination strategy toward more local efforts that could appeal to younger people or those who may not yet have gotten a shot. Mr. Biden and Dr. Anthony S. Fauci, the nation’s top expert on infectious diseases, recently answered questions about vaccine hesitancy from several young YouTube influencers. And last week, top health officials highlighted efforts by popular dating apps to encourage singles to promote their vaccination status on their dating profiles.
Andy Slavitt, one of Mr. Biden’s virus advisers, said the administration was encouraging states to use creative means — including lotteries or other financial incentives — to get people vaccinated. The federal government is allowing states to use certain federal relief funds to pay for those types of programs.
New York state officials said the raffle program would be financed through federal Covid-19 relief and outreach funds.
It is a question that people around the world are asking, the one for which millions have an opinion but no one has an answer: Will the Tokyo Olympics happen this summer?
The organizers of the Tokyo Olympics said last week that they had entered what they called “operational delivery mode” for the Summer Games, another clear signal that they will plow ahead toward the opening ceremony, scheduled for July 23, regardless of the state of the pandemic.
Yet widely documented polling in Japan shows that most of the country’s population wants the Olympics to be either postponed again or canceled outright. The United States Department of State this week issued a Level 4 travel advisory for Japan — “Do not travel.” And members of the global health community, prominent business leaders and at least one key Olympic partner continue to voice concerns about the dangers posed by proceeding with the Games.
One of the latest warnings came Tuesday in an article published by the New England Journal of Medicine, in which public health specialists criticized the International Olympic Committee’s so-called playbooks. The packets, created in consultation with the World Health Organization, detail measures designed to keep athletes, other Olympic visitors and the broader Japanese population safe from the virus.
Lawyers representing the European Union said on Wednesday that they would seek penalties from AstraZeneca that could run into the billions of euros if the pharmaceutical company fails to deliver tens of millions of doses of Covid-19 vaccine that it is contractually required to supply.
In the first hearing in a lawsuit that the E.U. has brought against AstraZeneca, lawyers representing the bloc told the judges in a Brussels courtroom that they would seek €10 (about $12) a dose for each day that delivery is delayed, along with €10 million a day for each of four alleged breaches of contract.
The bloc is demanding 90 million doses from the company by the end of June, and another 180 million by the end of September. The proposed penalties, if accepted by the judge, would begin on July 1 and could quickly balloon into billions of euros.
The proposed penalty is much higher than the purchase price of the vaccine. The European Union has paid a little over €2 a dose, which AstraZeneca sold at cost when it was first introduced.
A European Commission spokesman on health issues, Stefan De Keersmaecker, said that the lawsuit’s prime goal was to get AstraZeneca to deliver the doses, not to extract money from the company. If the doses are delivered, he said, the demand for penalties would be dropped.
Rafaël Jafferali, a lawyer representing the bloc, said AstraZeneca “diverted” millions of doses from plants that were supposed to produce vaccines for the bloc and shipped the doses to other countries instead, including Britain — actions that Mr. Jafferali called a “flagrant breach of contract.”
He accused the company, which is based in Britain and Sweden, of misleading the European Commission for months with “calm and reassuring” messages that it would be able to fulfill its delivery promises.
Fanny Laune, another lawyer representing the European Commission, said that because of delays in AstraZeneca’s deliveries, “millions” of people in Europe would be deprived of vaccine protection.
“We need to vaccinate a lot, and we need to vaccinate quickly, to bring the mortality down,” Ms. Laune said.
AstraZeneca’s lawyers hit back at the Commission in court, calling the accusations “shocking.”
“Our fundamental principle is equitable global access to vaccines,” said Hakim Boularbah of Loyens & Loeff, a firm representing AstraZeneca. “The urgency is to vaccinate the whole global population.”
Developing and mass-producing a new vaccine in so short a time had never been done before, so the supply plan in the contract was “an estimate,” and was not binding, AstraZeneca’s lawyers argued. They said the company had no obligation to use all its production facilities to supply the European Union in preference over other countries.
AstraZeneca, they said, was “fully transparent” with the European Commission in late 2020, keeping the commission informed of expected delays because of production problems. The lawyers said the commission was now trying to “unilaterally rewrite” its contract with AstraZeneca by imposing new delivery deadlines.
The litigation between the pharmaceutical company and one of its biggest customers has damaged the reputations of both sides.
AstraZeneca has drawn much of the blame for the European Union’s slow vaccination start, with shortages of doses delaying the rollout in many member countries. The company has said production problems were to blame.
The bloc’s vaccination efforts have gained pace in recent weeks, and now appear to be on track to get at least one dose to 70 percent of its adult population by the end of June.
The Brussels court is expected to issue an emergency ruling on part of the lawsuit within a month. Under Belgian law, a separate lawsuit over damages would be tried in September.
The official Covid-19 figures in India grossly understate the true scale of the pandemic in the country. Last week, India recorded the largest daily death toll for any country during the pandemic — a figure that is most likely still an undercount.
Even getting a clear picture of the total number of infections in India is hard because of poor record-keeping and a lack of widespread testing. Estimating the true number of deaths requires a second layer of extrapolation, depending on the share of those infected who end up dying.
In consultation with more than a dozen experts, The New York Times has analyzed case and death counts over time in India, along with the results of large-scale antibody tests, to arrive at several possible estimates for the true scale of devastation in the country.
Even in the least dire of these, estimated infections and deaths far exceed official figures. More pessimistic ones show a toll on the order of millions of deaths — the most catastrophic loss anywhere in the world.
India’s official coronavirus statistics report about 27 million cases and over 300,000 deaths as of Tuesday. The country’s response to the pandemic has been further complicated this week by a cyclone that is battering India’s eastern coast, with winds of more than 95 miles per hour.
Even in countries with robust surveillance during the pandemic, the number of infections is probably much higher than the number of confirmed cases, because many people have contracted the virus but have not been tested for it. On Friday, a report by the World Health Organization estimated that the global death toll of Covid-19 may be two or three times higher than reported.
The undercount of cases and deaths in India is most likely even more pronounced, for technical, cultural and logistical reasons. Because hospitals are overwhelmed, many Covid deaths occur at home, especially in rural areas, and are omitted from the official count, said Kayoko Shioda, an epidemiologist at Emory University. Laboratories that could confirm the cause of death are equally swamped, she said.
Additionally, other researchers have found, there are few Covid tests available. Families are often unwilling to say that their loved ones have died of Covid. And the system for keeping vital records in India is shaky at best. Even before Covid-19, about four out of five deaths in India were not medically investigated.
After the European Union’s announcement on May 19 that vaccinated travelers coming from the United States can soon visit the bloc’s member nations, the Louvre and Sicily’s beaches once again feel within reach. Here are some things to keep in mind.
Because the United States remains closed off to international leisure travelers, aviation industry experts say there won’t be enough planes flying to cause a huge surge in Europe-bound flights from the United States.
Flight schedules are almost certain to change as summer rolls on. But John Grant, a senior aviation analyst at OAG, a travel data and insight provider, suggests that prospective passengers “look first at travel to those cities with a high frequency of service, perhaps at least twice daily, since those destinations with just one daily flight or less than daily services are likely to be the more vulnerable services for short notice cancellations.”
When booking a hotel, one thing to watch for is the credits-versus-refunds flash point: Although vaccines and the eagerness to travel may make the idea of a credit less odious than it seemed last spring, always ask about policy specifics.
And realize that any trip to Europe this summer will come down to managing expectations.
“Save the ‘must check all the boxes’ trip to Europe for a bit later, once all new protocol kinks have smoothed out,” said Louisa Gehring, the owner of Gehring Travel.