The Centers for Disease Control and Prevention released new guidance for schools on Friday, urging them to fully reopen and calling on local districts to tailor their public health measures to local coronavirus data.
The recommendations signal a change from the C.D.C.’s past guidelines for schools and arrive less than a month before the first day of school for some districts.
Here’s what we know.
“Layered” prevention strategies
The new guidance continues to recommend that students be spaced at least three feet apart, but schools can rely on combining other strategies, like indoor masking, testing and enhanced ventilation, if such spacing would prevent them from fully reopening.
The guidance suggests masks for all unvaccinated students, teachers or staff members.
The guidance relies greatly on the concept of “layered” prevention, or using multiple strategies at once, like regular screening testing, improving ventilation, promoting hand washing and contact tracing combined with isolation or quarantine, in addition to social distancing and masking.
It also strongly urges schools to promote vaccination, which it called “one of the most critical strategies to help schools safely resume full operations.” But a vaccine has not been authorized for children younger than 12, so a large percentage of students would not be protected from the virus in that manner.
A more local approach
The issue of school closures has been contentious and divisive since the pandemic began, and advising school districts has been fraught for the C.D.C. The updated guidance acknowledges that a uniform approach to regulating schools is not useful when virus caseloads and vaccination rates vary so greatly, and suggests that local officials decide on the best precautions for their schools.
In order to do so effectively those officials should closely monitor the virus in their areas, and if districts choose to remove prevention strategies they should remove one at a time, monitoring for any increases in Covid-19, the recommendations say.
The virus and children
Though there are far fewer cases overall than during the winter peak, children have increasingly made up a greater proportion of cases as the pandemic has gone on and, recently, as more adults have been vaccinated.
Serious illnesses and death among children have been rare, and young children are also less likely to transmit the virus to others than are teens and adults. But scientists are concerned about an inflammatory syndrome that can emerge in children weeks after they contract the virus, even those who were not symptomatic when they were infected, and some children experience lingering symptoms often known as long Covid.
And the highly transmissible Delta variant is spreading rapidly in parts of the country with low rates of vaccination — the C.D.C. estimates it is now the dominant variant in the country. Studies suggest that vaccines remain effective against the Delta variant.
Africa has just had its “worst pandemic week ever,” the World Health Organization said on Thursday. The continent is short of vaccines, and the coronavirus is sickening its young people and overwhelming its already fragile health care systems.
More than 251,000 new cases were reported in Africa in the week ending July 4, a 20 percent increase from the previous week, according to Dr. Matshidiso Moeti, the W.H.O. regional director for Africa.
For several weeks now, the continent has been experiencing a brutal wave of infections driven by the more contagious Delta variant, which is increasing hospitalization and fatalities, filling intensive-care beds, depleting oxygen supplies and pushing governments to institute new lockdown measures.
Sixteen African countries are reporting a resurgence in infections, with Malawi and Senegal added to the list this week. New case counts are doubling every 18 days, Dr. Moeti said, and have been rising for seven straight weeks.
“A few weeks ago, we projected this milestone would be reached shortly, and it brings me no joy to be right,” Dr. Moeti said at a news conference on Thursday. “For Africa, the worst is yet to come,” she warned, adding, “The end to this precipitous rise is still weeks away.”
A third wave of the pandemic is ripping through countries mainly in southern and eastern Africa, and one country in North Africa — Tunisia — is experiencing its fourth wave.
Namibia, a nation of just over 2.5 million people, has been recording more than 1,000 new cases a day, and several senior government officials have succumbed to the virus. A spike in cases in Zambia has pushed the government to restrict social gatherings and close schools.
In Uganda, which was praised for its initial virus response, hospitals have been stretched thin, with some patients racking up huge medical bills. Rwanda restricted movement in its capital late last month, and Kenya instituted partial lockdowns and extended curfew hours in over a dozen counties where the Delta variant was contributing to surges.
Many African countries continue to face challenges in detecting and sequencing virus variants, Dr. Moeti said. Testing and tracing remain limited, as well: In a continent of 1.3 billion people, just over 54 million virus tests have been conducted, according to Dr. John Nkengasong, the director of the Africa C.D.C.
But the biggest challenge has been vaccination. With just over 53 million doses administered, only about 1 percent of Africa’s population is fully vaccinated.
African officials have accused wealthy nations of hoarding vaccine doses while millions of Africans remain vulnerable. Most African countries are dependent on the Covax vaccine-sharing initiative, which has been severely hampered by the Indian government’s decision in April to hold back doses manufactured there for domestic use and restrict exports.
As cases surge in Africa, some wealthy nations have begun donating vaccine doses to nations on the continent. And as more supplies come in, health officials are urging African countries to prepare to receive and administer the doses quickly.
“Governments and partners can do this,” Dr. Moeti said, “by planning to expand vaccination sites, improving cold chain capacities beyond capital cities, sensitizing communities to boost vaccine confidence and demand, and ensuring operational funding is ready to go when it is needed.”
Pfizer and BioNTech announced on Thursday that they were developing a version of the coronavirus vaccine that targets Delta, a highly contagious variant that has spread to nearly 100 countries. The companies expect to begin clinical trials of the vaccine in August.
Pfizer and BioNTech also reported promising results from studies of people who received a third dose of the original vaccine. A booster given six months after the second dose of the vaccine increases the potency of antibodies against the original virus and the Beta variant by five- to tenfold, the companies said.
Vaccine efficacy may decline six months after immunization, the companies said in a news release, and booster doses may be needed to fend off virus variants.
But the companies’ assertions contradict other research, and several experts pushed back against the claim that boosters would be needed.
“There’s really no indication for a third booster or a third dose of an mRNA vaccine, given the variants that we have circulating at this time,” said Dr. Céline Gounder, an infectious disease specialist at Bellevue Hospital Center in New York. “In fact, many of us question whether you will ever need boosters.”
Federal agencies also sounded a dubious note on Thursday night. Generally, Americans who have been fully vaccinated do not need a booster shot at this time, the F.D.A. and the Centers for Disease Control and Prevention said in a joint statement.
A ceremony marking the Olympic torch’s arrival in Tokyo was held in a nearly empty park on Friday, a day after the city declared a new state of emergency over a rise in Covid-19 cases and organizers of the Summer Games said they would bar spectators from most events.
Tokyo’s rising numbers are part of a surge across the Asia Pacific region, where countries that once led the world in containing the virus are grappling with new variants and a lack of vaccines.
New outbreaks are bringing back restrictions unseen for months, in places where the authorities once kept transmission relatively low — relying heavily on mask wearing, contact tracing and social distancing — but have been unable to vaccinate at a pace that would significantly tamp down infections.
Even the region’s richest countries have made little progress in their vaccination drives. Less than a third of the populations of Australia, Japan, New Zealand and South Korea, for instance, have gotten even one dose of a coronavirus shot, according to a New York Times tracker. And in several middle-income countries whose access to vaccines has been hindered by supply constraints or other factors, the one-dose figure is either in single digits or low double digits.
As the more contagious Delta variant ripples through the region, many governments are reimposing harsh restrictions on movement and socializing that many had considered a relic of the pandemic’s early, anxious months.
Sydney, Australia’s largest city, reported 38 cases on Thursday, its highest daily caseload yet. The city is under a stay-at-home lockdown until July 17, and the authorities warned on Friday, as they tightened restrictions further, that it could be extended.
In Southeast Asia, which saw one of its deadliest days of the pandemic on Thursday, new cases and restrictions are rising in tandem in several countries. In Myanmar, where health workers have been striking to protest a military coup, cases are rising sharply, and the military said on Friday that it would close schools nationwide for two weeks.
In Vietnam on Friday, the government began restricting movement in Ho Chi Minh City, the commercial capital. And in Thailand, where the government announced a new round of lockdown measures, a terminal at Bangkok’s main international airport was being converted into a field hospital.
People in several Malaysian cities are suffering amid strict lockdowns, as the country reports Southeast Asia’s highest per capita caseload, about 22 per 100,000, according to a New York Times database. Neighboring Indonesia has seen daily records of both cases and deaths this month, and doctors there who received the Sinovac shot have been falling ill or dying. The Indonesian capital, Jakarta, added about 13,000 new cases on Thursday alone, as health officials blamed the surge on the Delta variant.
In East Asia, South Korea reported 1,316 new cases on Friday, its highest daily tally of the pandemic. The government has said it would raise restrictions to the highest level in Seoul, the capital, and some neighboring regions starting on Monday. Schools will be closed, bars and nightclubs will be shut, and public meetings will restricted to two people after 6 p.m.
And in Tokyo, a fourth state of emergency will also take effect on Monday, less than two weeks before the start of the Olympics. Restaurants, department stores and other businesses will be asked to close early, and people will be asked not to gather in public to watch the Games.
Prime Minister Yoshihide Suga of Japan has said that if vaccinations pick up and the strain on hospitals eases, the government will consider lifting the emergency before Aug. 22, when it is set to expire. Yet his own Covid-19 adviser has warned that the Olympics — which most Japanese people had hoped would be canceled — could prompt new infections. At least four members of Olympic teams have already tested positive.
Haiti, the only country in the Americas without a Covid-19 vaccine campaign, is also the country with one of the world’s most dysfunctional health care systems.
Even as Haitians struggle to understand a shifting political crisis in the wake of the assassination of the nation’s president and worry about a surge in violence on the streets, looming in the backdrop is a pandemic whose scale is essentially unknown.
The country of 11 million people has yet to receive its first doses from the Covax vaccine-sharing program, making it one of few places that have not started an inoculation campaign.
Having never fully recovered from a 2010 earthquake that destroyed the Health Ministry’s building and 50 health care centers, Haiti has long depended on billions of dollars of foreign aid and the work of nongovernmental organizations to provide basic services.
But even before the assassination of President Jovenel Moïse this week, violence posed an increasing challenge to those working to deliver assistance. Humanitarian groups have become primary targets, and last month Doctors Without Borders evacuated some of its staff members and closed an emergency center in Haiti after gangs attacked it.
The dozens of armed gangs that control more than a third of the capital have also killed hundreds of people and impelled thousands to flee their homes over the past year.
International organizations and humanitarian groups warn that the assassination threatens to worsen a crisis that has been building for more than a year, ever since Mr. Moise’s decision to remain in office after opponents said his term had expired essentially paralyzed the government.
On Friday, UNICEF said that nearly one-third of all children in Haiti — about 1.5 million of them — were in urgent need of emergency relief because of the rising violence.
Against this overall backdrop, many in the country have viewed the pandemic as an abstraction. But there are indications that the coronavirus is far more widespread than officially reported.
The neighboring Dominican Republic, which has roughly the same size population, has reported more than 330,000 cases and nearly 4,000 deaths. Haiti has registered 19,000 cases and 467 deaths — but hospitals have reported struggling in recent weeks to find enough oxygen for a surge in patients.
UNICEF said that some patients had died because gang violence prevented ambulances from reaching them with oxygen and emergency treatment. “Amidst the upsurge of coronavirus cases in Haiti, any additional day without vaccine puts hundreds of lives under threat,” Bruno Maes, the organization’s Haiti representative, said on Friday.
The Rev. Richard Frechette, a doctor at St. Luke’s Hospital in Port-au-Prince, told the humanitarian aid organization Direct Relief that he had pleaded with gang leaders to allow the delivery of critical supplies, including oxygen.
“If the streets turn into looting and riots, we’re not going to be able to get oxygen,” he said. “That always happens when there’s instability.”
Haiti is due to receive about six million coronavirus vaccine doses from the United States, but it is unclear when they might be delivered.
In the latest volley of the debate over the origins of the coronavirus, a group of scientists this week presented a review of scientific findings that they argue shows a natural spillover from animal to human is a far more likely cause of the pandemic than a laboratory incident.
Among other things, the scientists point to a recent report showing that markets in Wuhan, China, had sold live animals susceptible to the virus, including palm civets and raccoon dogs, in the two years before the pandemic began. They observed the striking similarity that Covid-19’s emergence had to other viral diseases that arose through natural spillovers, and pointed to a variety of newly discovered viruses in animals that are closely related to the one that caused the new pandemic.
The back and forth among scientists is taking place while intelligence agencies are working with an end-of-summer deadline to provide President Biden with an assessment of the origin of the pandemic. There is now a division among intelligence officials as to which scenario for viral origin is more likely.
The new paper, which was posted online on Wednesday but has yet to be published in a scientific journal, was written by a team of 21 virologists. Four of them also collaborated on a 2020 paper in Nature Medicine that largely dismissed the possibility that the virus became a human pathogen through laboratory manipulation.
In the new paper, the scientists provided more evidence in favor of the virus having spilled over from an animal host outside of a laboratory. Joel Wertheim, a virologist at the University of California, San Diego, and a co-author, said that an important point in support of a natural origin was the “uncanny similarity” between the Covid and SARS pandemics. Both viruses emerged in China in the late fall, he said, with the first known cases popping up near animal markets in cities — Wuhan in the case of Covid, and Shenzen in the case of SARS.
If everyone in attendance wears a mask, keeps their hands clean and has recently tested negative for the coronavirus, large concerts can be held safely indoors without requiring social distancing, researchers in Paris said on Thursday, based on an experiment they ran in May.
The Paris Public Hospitals, which led the experiment, gathered 6,678 volunteers and divided them randomly into two groups: about two-thirds of the volunteers attended a special concert conducted for the experiment at the Accor Arena, and the rest did not. Half of the volunteers had received at least one vaccine dose.
All of the volunteers were tested a week later, and the results showed no significant difference between the two groups. About 0.2 percent of the concertgoers’ tests came back positive, nearly the same positivity rate as the Île-de-France region, which includes Paris, over the two weeks preceding the event.
The researchers said that analysis of saliva samples taken at the concert showed afterward that five of the eight concertgoers who eventually tested positive already had the virus when they arrived at the arena.
The results suggest that “participating in a large indoor live concert with no physical distancing” was “not associated with an increased risk of Covid infection,” the Paris Public Hospitals said in a statement.
The results were encouraging for French people who are starting to enjoy the complete reopening of public gathering places in their country, after three lengthy lockdowns over the course of the pandemic and a curfew that was imposed in October. Nightclubs, the last sector still subject to restrictions in France, are expected to reopen on Friday after being closed for 15 months.
But the concert experiment followed strict sanitary protocols and took other measures that might not be maintained in commercial public settings, including screening the audience and keeping the bars and smoking rooms at the venue closed.
The volunteer attendees were all 18 to 45 and had declared that they had no Covid symptoms, no other significant health conditions and no recent contact with an infected person. Compliance with the facial mask requirement was tracked and evaluated by a continuous video-capture artificial intelligence system.
Experimental concerts previously conducted in Barcelona, Spain, in March and Liverpool, England, in May yielded similar conclusions that indoor events held with strict safety measures would not lead to a significant rise in infections.
The coronavirus situation in France remains worrisome. Daily new case reports have risen significantly over the past week in 11 regions of the country, including Île-de-France, and the more contagious Delta variant accounted for more than 40 percent of the new cases. Vaccination efforts have begun to stall with just 37.6 percent of the total population fully protected, and the government, fearing a new wave of infections before the end of the summer, is mounting a push to speed them up again.
As countless fans across England gathered on Wednesday to watch their team defeat Denmark in the European Championship semifinal, coronavirus cases have spiked across the nation and researchers have hinted at a possible link between the sudden rise and gatherings for games that have mostly ignored social distancing measures.
Research released on Thursday showed that men in England were currently 30 percent more likely to be infected with the coronavirus than women — a finding that could dampen the excitement of the legions of mostly male fans hoping to celebrate a victory in the European Championship soccer final on Sunday.
Steven Riley, a professor of infectious disease dynamics at Imperial College London who was one of the report’s authors, said the higher rates of infections among men were probably explained by changes in social behaviors like watching soccer.
The European Championship soccer tournament started on June 11 and ends on Sunday, and crowds have been gathering in London and across Britain to watch the matches in pubs, restaurants and on outdoor screens.
Researchers at Imperial College London also found that from June 24 to July 5, the number of coronavirus cases had quadrupled across England and had risen eightfold in London.
The World Health Organization warned last week that the games, held in cities across Europe, had driven a rise in coronavirus cases. The two semifinals this week were played at Wembley Stadium in London — including England’s hard-fought win against Denmark on Wednesday night — as will the final on Sunday. Attendance at each game has been about 60,000 people.
Germany’s Interior minister, Horst Seehofer, has called the decision by UEFA, European soccer’s governing body, to allow large crowds in stadiums “utterly irresponsible.” Yet the British authorities have gone ahead, filling Wembley at two-third capacity.
Although those in attendance at Wembley were required to provide proof of a full coronavirus vaccination or a negative test result taken 48 hours before the game, few people wore masks in the outdoor stadium or its inner concourses, and trains were packed tightly before and after the game.
Coronavirus infections have quadrupled in England in recent weeks, according to the study from Imperial College London, which was published on the government’s website. On Wednesday, Britain reported more than 32,500 new cases and 33 deaths.
England’s last pandemic restrictions are set to be lifted by July 19, even as public health experts said the nation could face 50,000 new daily infections later this month.
In a letter published in The Lancet on Wednesday, 122 scientists and doctors accused the British government of conducting a “dangerous and unethical experiment” by letting the virus circulate widely, while half of the population has yet to be fully vaccinated.
The authorities also said on Thursday that fully vaccinated travelers returning to England’s from countries deemed to be a mid-level risk — those on the “amber” list on its stoplight-code system — would no longer have to quarantine.
The move could prompt many in Britain to book vacations in European destinations like France, Italy, Portugal and Spain, although some countries have in return imposed new restrictions on travelers arriving from Britain.
As criticism mounts about the Indian government’s handling of the coronavirus pandemic, the health minister, Harsh Vardhan, has stepped down as part of a major cabinet reshuffle.
The overhaul of government positions was carried out as Prime Minister Narendra Modi and his government come under increasing fire for their handling of the crisis. Critics have accused the authorities of failing to adequately prepare for a second wave of the virus after pronouncing the end of the pandemic this year — just before a devastating new outbreak unfolded, which saw untold numbers of people in a desperate search for scarce hospital beds, medical oxygen and other lifesaving help.
Arati Jerath, a political analyst and writer, said, “Clearly there is realization that the pandemic was mismanaged, that there is a great deal of unhappiness.”
“Mr. Modi was the face of the fight against Covid, so I think he has made Harsh Vardhan the scapegoat,” she added.
Mansukh Mandaviya, minister of state for chemicals and fertilizers, was appointed to take Dr. Vardhan’s place during what the government has described as a critical moment to stave off a third wave.
The government has also been criticized for continuing shortages of Covid-19 shots, despite the country’s being home to the world’s largest vaccine maker, the Serum Institute of India, which is producing tens of millions of AstraZeneca doses per month.
Only 4.9 percent of India’s nearly 1.4 billion people are fully vaccinated, and health officials are warning that the pace of immunization could be too slow to prevent another major outbreak.
In early March, Dr. Vardhan, a member of Parliament and an ear, nose and throat specialist, said India was “in the endgame” of the pandemic. Three weeks later, India halted vaccine exports as case numbers surged.
In the latest reshuffle, Mr. Modi appointed nearly three dozen ministers — some of whom were promoted to cabinet-level posts — while a dozen ministers were dropped, including two seen by members of Mr. Modi’s Bharatiya Janata Party as having badly controlled the messaging around the government’s pandemic response.
Those two ministers were Prakash Javadekar, who oversaw information and broadcasting, and Ravi Shankar Prasad, the minister tasked with enforcing an unpopular new law that makes media companies, including social media platforms, more liable for content. The law is being challenged in several courts around India.
Viruses evolve. SARS-CoV-2, the virus that causes Covid-19, is no exception. So the emergence of variants is no surprise, and not every new genetic mutation poses a serious threat.
But in recent weeks, a growing drumbeat of news coverage has started to raise alarm about Lambda, a variant first detected late last year in Peru. The variant, initially known as C. 37, has spread rapidly through parts of South America. On June 14, the World Health Organization designated it as a “variant of interest,” meaning, essentially, that experts suspect it could be more dangerous than the original strain.
Only a handful of studies have looked at Lambda so far. Here’s what we know:
It has spread fast. It has been detected in at least 29 countries and has become especially prevalent in Peru, Chile and other parts of South America.
It has eight notable mutations, some of which are present in other variants and might make the virus more infectious or help it evade the body’s immune response.
Preliminary laboratory studies suggest that the variant may be more transmissible and that the body’s antibodies may be less effective against it. But vaccine-induced antibodies are still able to neutralize the virus, which suggests that vaccines should still provide protection against it.
Although more real-world data is needed, there is not yet any evidence that Lambda poses more risk than other circulating variants, like Delta. “I don’t think there’s any more reason to be concerned than before we knew about this variant,” said Nathaniel Landau, a microbiologist at the New York University Grossman School of Medicine. “There’s no reason to think that this is now something worse than Delta.”
The International Monetary Fund’s executive board approved a plan to issue $650 billion worth of reserve funds to help troubled countries purchase vaccines, finance health care and pay down debt. If approved by the I.M.F.’s board of governors, as is expected, the reserves could become available by the end of August.
How will the I.M.F. create this fund?
The reserve fund will be created through an allocation of Special Drawing Rights, and it will be the largest such expansion of the asset in the organization’s nearly 80-year history.
Special Drawing Rights, or S.D.R.s, were created in the 1960s and are essentially a line of credit that can be cashed in for hard currency by member countries of the I.M.F. They are intended to help countries bolster their existing reserves and make the global economy more resilient.
Each of the I.M.F.’s 190 countries receives an allotment of S.D.R.s based on their shares in the fund, which track with the size of a country’s economy. The drawing rights are not a currency, and therefore cannot be used to buy things on their own. But they can be traded among member countries for currencies that can. Their value is based on a basket of international currencies — the U.S. dollar, euro, Chinese renminbi, Japanese yen, and British pound sterling — and is reset every five years.
To utilize the S.D.R.s, countries can agree to trade this interest-bearing asset with other countries in exchange for cash. The I.M.F. serves as a middleman to help facilitate the transaction. If the United States buys a batch of S.D.R.s from, say, Angola, it would earn interest on those assets. And Angola, which would be paid for the sale in U.S. dollars, could use the money to buy what it needs, such as vaccines to inoculate its population against Covid-19.
The plan approved by the I.M.F. executive board would effectively create $650 billion worth of S.D.R.s. Poor countries could then trade their share of those with wealthier countries to get hard currency to fund vaccines.
Why is the plan controversial?
While the idea of new S.D.R. allocations was introduced last year, the United States, under the Trump administration, prevented it from moving forward. It argued at the time that boosting the emergency reserves was an inefficient way to provide aid to poor countries and that doing so would provide more resources to advanced economies that do not need the help, like China and Russia, who would get a large share of the S.D.R.s that are approved.
Republicans have continued this argument, seizing on the issue as a way to criticize President Biden, who supports the allocation, for not putting “America first.”
At a Senate hearing in March, Senator John Kennedy, Republican of Louisiana, tried to make the case to the Treasury secretary, Janet L. Yellen, that the United States would be subsidizing loans to countries if it buys S.D.R.s, essentially putting taxpayers at risk.
Republicans such as Mr. Kennedy argue that the S.D.R. allocation would do more to benefit American adversaries than the developing countries it is intended to help. He argues that China and Russia would get the equivalent of a combined $40 billion.
Ms. Yellen has dismissed both notions, arguing that any borrowing the United States did to buy a country’s S.D.R.s would be offset by the interest it collects on the asset. The Treasury Department also did not buy the claim that allocating the I.M.F. reserves would benefit China and Russia, as they have shown little use for the S.D.R.s and the United States would not be inclined to cut a deal with such rivals.
Eswar Prasad, the former head of the I.M.F.’s China division, agreed that any benefit to China or Russia from the S.D.R.s would be negligible and that American taxpayers have nothing to lose.
“Any such conversions of S.D.R.s into U.S. dollars would be guaranteed by the I.M.F., so there are no risks to the U.S.,” he said.
Will the new reserves be enough to developing countries fight the pandemic?
Some have said the I.M.F. should be doing more.
The United Nations Conference on Trade and Development called earlier this year for $1 trillion worth of Special Drawing Rights to be made available by the I.M.F. as a “helicopter money drop for those being left behind.”
To address some of these concerns, the I.M.F. is working to develop a new trust fund where wealthier countries can channel their excess S.D.R.s. The goal is to create a $100 billion pot of money that less developed countries can borrow from to use toward expanding their health care systems or addressing climate change in conjunction with existing I.M.F. programs.
Other changes are also in the works to address the political sensitivity over how the reserves are used. At the urging of the United States, the I.M.F. is working to create greater transparency around how the assets are being used so that is clear that American adversaries are not benefiting from the proceeds.