Covid-19 News: Israel, A World Leader In Vaccinations, Faces A New Outbreak – The New York Times

Showing virus passes before entering a concert in Tel Aviv in March.Credit…Dan Balilty for The New York TimesJERUSALEM — Israel has been a trailblazer in the post-pandemic world, largely returning to normal in May following one of the world’s fastest vaccination drives.

But dozens of new cases recently emerged at schools in two cities, Modiin and Binyamina, leading to hundreds of people being quarantined. Israel has made 12- to 15-year-olds eligible for vaccination, but many have yet to get shots.

Despite the new outbreak, the country’s current death rate remains close to zero, and only 26 of 729 active coronavirus patients were hospitalized, according to data released by the Health Ministry. And the overall daily caseload remains far from the country’s peak in mid-January, when the average hit more than 8,000 daily cases.

The containment effort has struggled to have an impact as the virus continues to spread through several cities. Many of those who contracted the virus had been vaccinated, according to the director general of the Health Ministry, Prof. Chezy Levy, though he did not specify if they had had one or two doses.

The Delta variant is unlikely to pose much risk to people who have been fully vaccinated, experts have said. The country has relied on the two-dose mRNA vaccines made by Pfizer-BioNTech and Moderna.

Some Israeli officials and health experts have attributed the outbreaks to the Delta variant, and point to international travelers as a potential source of the outbreaks.

According to Anat Danieli, a Health Ministry spokeswoman, the Delta variant had been identified in 180 samples as of last Sunday. But it was unclear how many of the new cases involved the variant, as the testing can take up to 10 days.

Since last Saturday, the country’s rolling seven-day average of new cases has grown from fewer than 25 to more than 72, according to the Our World in Data project at Oxford University.

Before the recent outbreak, the daily caseload had fallen close to zero. About 57 percent of the country’s population has already been given two shots of Covid vaccine.

To deal with the sudden outbreak, the Israeli prime minister, Naftali Bennett, reinstated a ministerial crisis committee, known as the coronavirus cabinet. On Wednesday, Israel’s Tourism Ministry said that it would postpone its resumption of issuing individual tourist visas from July 1 to Aug. 1.

Israeli officials fear the country may have eased too many of its antivirus restrictions too quickly, and on Thursday, the Health Ministry said that the government would assess whether to reintroduce a requirement for people to wear masks in indoor public places, regardless of vaccination status, should the daily caseload exceed 100. On Friday, after the daily caseload hit 227, the ministry said it went ahead with the requirement, which began at midday, and thousands of participants at a pride march in Tel Aviv were advised to wear masks.

The announcement came less than two weeks after the country’s indoor mask mandate was lifted and less than a month after the end of capacity restrictions in public spaces, as well as the requirement to show proof of full vaccination against the coronavirus.

Nachman Ash, a senior official overseeing the Israeli pandemic response, also asked residents to avoid unnecessary international travel.

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Biden Promotes Vaccinations in North CarolinaAt an event for vaccine canvassers in Raleigh, President Biden urged Americans to get vaccinated to be protected from the coronavirus and its Delta variant.Statewide, case deaths are down over 90 percent in the last five months. All of this is great news, but here’s the deal: For all the progress we made as a country — hospitalizations and deaths are down drastically in places where people are getting vaccinated — the data couldn’t be clearer: If you’re vaccinated — if you’re vaccinated, you’re safe; you are still at risk of getting seriously ill or dying if you, in fact, have not been vaccinated. That’s just a fact. Over 150 million Americans have gotten fully vaccinated, and they’re safe and protected now, including against the Delta variant. They’re getting back to living their lives and spending time with their loved ones. And we need more people to get fully vaccinated to finish the job. That’s why I’m here. 73 percent of the shots administered at community health centers through the federal program we have and more than 58 percent of the shots administered in federally run vaccination sites have gone to people of color. It makes a gigantic difference. And across the nation, people of color accounted for more than half of all the vaccinations in the last month. The more we close the racial gap on vaccination rates, the more lives we can save.

At an event for vaccine canvassers in Raleigh, President Biden urged Americans to get vaccinated to be protected from the coronavirus and its Delta variant.CreditCredit…Doug Mills/The New York TimesPresident Biden implored Americans on Thursday to “knock on doors and talk to friends and neighbors” about getting vaccinated, as the White House opened a campaign-like blitz to persuade people around the country to get their shots.

Mr. Biden’s speech, in North Carolina, came as the government is shifting its strategy from mass vaccination sites to a more localized effort — deploying top officials to local communities, with an eye toward younger Americans who have not had the access or are reluctant to get vaccinated.

“This can be among the most important things you do,” Mr. Biden said, before reminding the crowd of dozens of canvassers and attendees at Green Road Community Center in Raleigh that more than 600,000 Americans have died from Covid-19.

The White House has sent other big names out on the road recently, as well. The first lady, Jill Biden, visited vaccination sites in Florida on Thursday and planned to travel to at least five states between this week and July 4. (It is a traveling schedule that, at this point, is busier than her husband’s.)

Dr. Anthony S. Fauci knocked on doors last weekend in a predominately African American neighborhood in Washington, and Douglas Emhoff, Vice President Kamala Harris’s husband, visited a barbershop in Chicago this week to learn why residents were turning away shots.

The message has been clear: Vaccines are available and beneficial, with mobile vaccination units in many neighborhoods and extended hours at pharmacies. On Thursday, Mr. Biden also encouraged those in Raleigh to take advantage of free trips by ride-hailing companies to vaccination sites.

The flurry of travel reflects the sense of urgency as the pace of vaccinations slows and the White House acknowledges that the country will most likely fall short of Mr. Biden’s goal of partially inoculating 70 percent of American adults by July 4.

Health officials also warn of the rising danger of the Delta variant, a more contagious version of the coronavirus first identified in India. Dr. Fauci said this week that the variant accounted for an estimated 20 percent of new cases. Experts say the Delta variant is unlikely to pose much risk to people who have been fully vaccinated.

“You know there’s going to be others, as well,” Mr. Biden said of the variant. “You know it’s going to happen. We got to get our young people vaccinated. So talk to those moms when you knock on the doors.”

North Carolina exemplifies many of the challenges the Biden administration is facing. Just 45 percent of the state is partially vaccinated, and 7 percent of those between ages 18 and 24 have received at least one shot, according to the state’s Department of Health and Human Services.

Dr. David Wohl, the medical director of vaccination clinics at the University of North Carolina, Chapel Hill, said that to speed vaccinations, Mr. Biden would need to treat the outreach “like a political campaign.”

“We have a tall order in front of us,” Dr. Wohl said. “I think he’s walking the walk. I think he’s saying you’re not impervious to this virus. You can get sick.”

Experts know that one way to address vaccine hesitancy is for individual doctors to recommend vaccination, or offer the vaccine to patients who may come in for other reasons.

Mr. Biden also used his speech to acknowledge the distrust in the Black community about the vaccine.

Lazaro Gamio contributed reporting.

A Maricopa County constable posting an eviction order for non-payment of rent last October in Phoenix.Credit…John Moore/Getty ImagesThe Centers for Disease Control and Prevention on Thursday approved a one-month extension of the national moratorium on evictions, scheduled to expire on June 30, as officials emphasized this will be the final time they will push back the deadline.

The moratorium, instituted by the agency last September to prevent a wave of evictions spurred by the economic downturn associated with the coronavirus pandemic and extended earlier this year, has significantly limited the economic damage to renters and sharply reduced eviction filings.

On Thursday, the C.D.C. director, Dr. Rochelle P. Walensky, signed the extension, which goes through July 31, after a week of internal debate at the White House over the issue.

Local officials and tenants rights groups have warned that phasing out the freeze could touch off a new, if somewhat less severe, eviction crisis than the country faced last year during the height of the pandemic.

White House officials agreed and pressed reluctant C.D.C. officials to extend the moratorium, which they see as needed to buy them more time to distribute $21.5 billion in emergency federal housing aid funded by a pandemic relief bill passed this spring.

Administration officials, speaking on a conference call with reporters on Thursday, unveiled a range of other actions intended to blunt the impact of lifting the moratorium and the lapsing of similar state and local measures.

Among the most significant is a new push by the Justice Department, led by Associate Attorney General Vanita Gupta, to coax local housing court judges to slow the pace of evictions by forcing landlords to accept federal money intended to pay back rent.

In a letter to state court officials, Ms. Gupta urged judges to adopt a general order requiring all landlords to prove they have applied for federal aid before signing off on evictions, while offering federal funding for eviction diversion programs intended to resolve landlord-tenant disputes.

Other initiatives include a summit on housing affordability and evictions, to be held at the White House later this month; stepped-up coordination with local officials and legal aid organizations to minimize evictions after July 31; and new guidance from the Treasury Department meant to streamline the sluggish disbursement of the $21.5 billion in emergency aid included in the pandemic relief bill in the spring.

White House officials, requesting anonymity because they were not authorized to discuss the issue publicly, said recently that the one-month extension, while influenced by concerns over a new wave of evictions, was prompted by the lag in vaccination rates in low-income communities.

Ms. Walensky was initially reluctant to sign the extension, according to a senior administration official involved in the negotiations. She eventually concluded, the official said, a flood of new evictions could lead to greater spread of the virus by displaced tenants.

Forty-four House Democrats wrote to Ms. Walensky, on Tuesday, urging them to put off allowing evictions to resume. “By extending the moratorium and incorporating these critical improvements to protect vulnerable renters, we can work to curtail the eviction crisis disproportionately impacting our communities of color,” the lawmakers wrote.

Groups representing private landlords maintain that the health crisis that justified the freeze has ended and that continuing the freeze even for an extra four weeks would be an unwarranted government intrusion in the housing market.

“The mounting housing affordability crisis is quickly becoming a housing affordability disaster fueled by flawed eviction moratoriums, which leave renters with insurmountable debt and housing providers holding the bag,” said Bob Pinnegar, president of the National Apartment Association, a trade group representing owners of large residential buildings.

A coronavirus testing site in Los Angeles in January. A study reinforced findings that the scope of contagion in America was much broader than data suggested early in the pandemic.Credit…Philip Cheung for The New York TimesFor every coronavirus infection that was recorded in the United States in mid-2020, nearly five asymptomatic cases went undetected, according to a new study by the National Institutes of Health.

The study, which was released on Tuesday, reinforced previous findings that the scope of contagion was much more widespread in the early months of the pandemic.

It also highlighted the vast gap in virus testing in many parts of the country and the disproportionately high infection rate among Black people at the time.

N.I.H. researchers estimated that there were as many as 20 million infections in the United States by mid-July 2020, far more than the three million cases that public health authorities recorded. Their findings were based on a yearlong study that began in April 2020, with researchers analyzing blood samples collected from more than 8,000 people, mostly from early May through July 31.

The study, published online in Science Translational Medicine, looked at 9,089 adults who had not been diagnosed with Covid-19 and found that about 4.6 percent of them carried antibodies suggesting that they had been infected with the coronavirus at some point. That suggested, the study said, “a potential 16.8 million undiagnosed infections by July 2020 in addition to the reported 3 million diagnosed cases in the United States.” Data released last summer by the Centers for Disease Control and Prevention similarly detailed a vast undercounting of infections.

The new study “helps account for how quickly the virus spread to all corners of the country and the globe,” Bruce J. Tromberg, director of the National Institute of Biomedical Imaging and Bioengineering, said in a statement. The institute is one of several at N.I.H. whose scientists are leading the effort to study the transmission of the virus, and it contributed to the report.

Dr. Tromberg said that the findings would help public health experts assess future measures to protect people from the coronavirus and from emerging, more transmissible variants. They also would provide more clarity for scientists who are tracking vaccine antibody-response changes over time, he said.

Among those who volunteered for the study, which was weighted for race and other factors, Black participants had the highest estimated rate of coronavirus antibodies in their blood (14.2 percent), more than five times the rate for white participants (2.5 percent).

Researchers also found that the seropositivity rate was higher in females than in males, and for the study’s youngest participants, ranging in age from 18 to 44.

“This wide gap between the known cases at the time and these asymptomatic infections has implications not only for retrospectively understanding this pandemic but for future pandemic preparedness,” Kaitlyn Sadtler, a top N.I.H. official and a senior co-author of the study, said in a statement.

Burying a Covid-19 victim in São Paulo.Credit…Mauricio Lima for The New York TimesIn Brazil, Latin America’s largest nation, the coronavirus has found remarkably fertile ground, turbocharging the outbreak that has turned South America into the hardest-hit continent in the world.

Brazil recently surpassed 500,000 official Covid-19 deaths, the world’s second-highest total, behind the United States. About 1 in every 400 Brazilians has died from the virus, but many experts believe the true death toll may be higher. Home to just over 2.7 percent of the world’s population, Brazil accounts for nearly 13 percent of recorded fatalities, and the situation there is not easing.

As the virus began spreading to remote corners of Brazil last year, it took an especially high toll in the Amazon region, where patients suffocated to death after President Jair Bolsonaro’s government was late to heed warnings about oxygen shortages. As the country struggles to vaccinate people, the region’s isolated villages, deep in the rainforest and often accessible only by river, still present a unique challenge.

The photographer Mauricio Lima traveled across Brazil to document the pandemic’s toll on cities and remote towns. See his photos here, along with reporting by Ernesto Londoño and Flàvia Milhorance.

“The newly arising variants, especially now the Delta variant, are a warning for us to continue to be careful,” Chancellor Angela Merkel of Germany told lawmakers.Credit…Michele Tantussi/ReutersChancellor Angela Merkel of Germany warned on Thursday that despite dropping numbers of new coronavirus infections, Europeans should not be deceived into thinking the pandemic is over.

“We need to remain vigilant,” Ms. Merkel told lawmakers in what may have been her final address to Parliament. Germans will elect new lawmakers in September, and Ms. Merkel is stepping down after 16 years in power.

“In particular, the newly arising variants, especially now the Delta variant, are a warning for us to continue to be careful,” the chancellor said.

European Union health officials are predicting that the more transmissible Delta variant, which was first detected in India, will make up 90 percent of all cases across the bloc by the end of August. They are urging people to get fully vaccinated as soon as possible, even as travel for summer vacations between the 27 member nations is allowed and encouraged.

On Thursday, Ms. Merkel called for E.U. member states to come up with a joint position on handling arrivals from countries where the Delta variant is dominant. This includes Britain, where Germany will play England in the European soccer championship on Tuesday, raising concerns in Berlin about the risk posed to fans traveling to the game.

Germany already requires anyone arriving from Britain to quarantine upon arrival, and the chancellor told lawmakers on Wednesday that she would raise the issue with European leaders in Brussels on Thursday. “In our country, if you come from Britain, you have to go into quarantine — and that’s not the case in every European country, and that’s what I would like to see,” Ms. Merkel said.

The Delta variant makes up about 15 percent of all new cases of the coronavirus in Germany, and officials are warning that could change within a matter of weeks.

In other news from around the world:

Rizieq Shihab, a radical cleric in Indonesia who attracted huge crowds last year on his return from self-imposed exile, was sentenced to four years in prison on Thursday for hiding that he had contracted the coronavirus. A three-judge panel found that he had spread false information by posting a video claiming to be healthy. The Muslim cleric, who had pledged to lead a “moral revolution,” was sentenced in May to eight months in prison for holding large gatherings in violation of coronavirus health protocols.

Russia on Thursday reported more than 20,000 new coronavirus cases and more than 550 deaths the previous day, reaching numbers unseen since January. Over the past two weeks, the country has had a surge in cases, driven in part by the Delta variant. The situation has been worsened by a sluggish vaccination process, with the government trying to speed it up.

Matshidiso Moeti, the World Health Organization’s regional director for Africa, said in a news briefing that rising coronavirus cases on the continent were outpacing vaccinations, driven in part by a surge in the Delta variant. Eighteen African nations have used over 80 percent of their vaccine stocks, highlighting the need for international solidarity to increase vaccine supplies there. Africa had relied on India as a vaccine producer before it was overwhelmed by its own second wave, she said.

Spain on Thursday approved a significant easing of coronavirus restrictions, lifting a requirement that residents must wear a mask outdoors. The measure, which comes into force on Saturday, removes a rule that had been in place since the country was first hit by the pandemic in March 2020. “Our streets, our faces will recover their normal aspect in the coming days,” Prime Minister Pedro Sánchez said ahead of the decision. It comes as Spain’s vaccination campaign has gathered pace. Just over 15 million residents, equivalent to 32 percent of Spain’s population, had been fully vaccinated by Thursday.

Visitors from Baltimore posing with characters in Times Square in May.Credit…Kirsten Luce for The New York TimesAs New York City fully reopens, tourism officials are hoping to revive a critical driver of its economy by making an urgent plea for visitors to start rushing back.

Armed with $30 million in federal aid, the city’s tourism promotion agency, NYC & Company, is developing an aggressive campaign to overcome New York’s image as the original epicenter of the coronavirus pandemic in the United States. They hope to lure 10 million visitors to the city for overnight stays or day trips between Memorial Day and Labor Day.

With most international travel still closed off, the vast majority of those visitors will be domestic vacationers, not the higher spending foreign tourists. Almost all of the city’s biggest foreign sources of visitors, including China and Brazil, are still prohibiting trips to the United States.

But after the pandemic virtually wiped out the city’s booming tourism industry and forced many of its big hotels to shut their doors, any and all visitors are welcome.

“What we realized is that we need to create an urgency to visit now,” said Fred Dixon, the chief executive of NYC & Company. He said that the agency’s surveys of residents of the Northeast showed that people “were very keen and eager to return to the city, but they were looking for the sign that it is the right time.”

That sign will come in the form of the city’s biggest advertising campaign in decades, including national TV ads with the theme “It’s time for New York City.” Still in production but scheduled to start appearing in two weeks, those ads will be aimed at persuading Americans who might otherwise have gone to Europe or elsewhere overseas to consider spending some time — and money — in New York instead.

A drive-through vaccination center at the City College of San Francisco in March.Credit…Jeff Chiu/Associated PressThe city of San Francisco said on Wednesday that it would require all 35,000 of its employees to be vaccinated against Covid-19 or risk losing their jobs, making it one of the largest U.S. municipalities to impose a vaccine mandate for public workers.

The requirement will take effect once a Covid vaccine receives full authorization from the Food and Drug Administration. The vaccines are currently being used in the United States under emergency authorizations.

City officials said that the requirement would promote safety in municipal workplaces and among the general public, given that police officers, firefighters, building inspectors and other city workers come into regular contact with members of the community.

“With those two things in mind — the safety of our employees and the safety of the public we serve — we made this decision,” said Carol Isen, San Francisco’s director of human resources. “We believe this step is a simple one to take. It’s safe, it’s very effective, and it’s going to guarantee the safety of all.”

San Francisco has one of the highest vaccination rates of any major U.S. city, with 80 percent of residents 12 and older having received at least one dose and 70 percent fully vaccinated, Mayor London Breed said this month. Ms. Isen said that informal surveys of city workers — many of whom live in other municipalities where vaccination rates are lower — suggested that at least 60 percent were fully vaccinated.

Under the new policy, starting on Monday, city employees will be required to show proof of their vaccination status within 30 days. City officials said that they would redouble efforts to get shots to those who haven’t had them, while allowing workers to request exemptions on medical or religious grounds.

Both Pfizer and Moderna, the makers of the two most widely used Covid shots in the United States, have applied for full F.D.A. approval for their vaccines, but it is unclear when regulators will make a decision.

Elsewhere in the United States, vaccine mandates have been met with opposition. This week, more than 150 staff members at a Houston-area hospital resigned or were fired for not following a policy that requires employees to be vaccinated against Covid-19.

San Francisco officials said that employees who did not meet the vaccine requirement could lose their jobs but added that firings would be a last resort. A recent outbreak of the Delta variant among unvaccinated residents in nearby Marin County — where more than 80 percent of people are fully inoculated — shows the need for everyone to receive the shots, officials said.

“We see that Delta did make its way through a cluster of unvaccinated people, and so we just wanted to make this move quickly,” Ms. Isen said. “We hope our employees respond to this in the spirit in which it’s offered — not as a punishment, but as a safety measure.”

A vaccination line in Sydney on Thursday. An outbreak follows months of near-zero community coronavirus transmission, but officials expect more cases to arise.Credit…Saeed Khan/Agence France-Presse — Getty ImagesA new Covid cluster in Sydney has grown to 49 cases, prompting a travel ban for the five million residents of Australia’s largest city and a return to mandatory mask-wearing, and infecting at least one state government minister.

Health officials in the state of New South Wales have been scrambling for more than a week to contain the outbreak, which began when a Sydney airport limousine driver tested positive for the highly contagious Delta variant. He was not vaccinated, in violation of public health guidelines, and is believed to have become infected while transporting a foreign airline crew.

As the police continue to investigate whether the driver and his employer should face criminal penalties or fines for not complying with Covid rules, Sydney has been forced to hunker down. Residents are being asked to work from home, where gatherings are now limited to five people.

The travel restrictions began late on Wednesday. Compounded by state border closures banning entry for anyone from Sydney, the stay-at-home orders have arrived at the start of winter break for schools, forcing tens of thousands of families to cancel travel plans.

Australia has all but eliminated community transmission of the coronavirus thanks to border closures, extensive contact-tracing and a practice of swiftly imposing local lockdowns for even small numbers of cases. The current outbreak in Sydney follows several months of near-zero Covid community transmission.

A stricter lockdown in the city has been avoided so far, officials said, because contact tracers have identified the source of nearly every case. Only three infections are still being investigated.

But with some of the cases being linked back to fleeting contact, with just a few seconds of shared air in a store or cafe, officials said they expect more cases and challenges to arise.

“Since the pandemic has started, this is perhaps the scariest period that New South Wales is going through,” the state premier, Gladys Berejiklian, told a news conference Thursday.

She added that she had been identified as a casual contact herself and had gotten tested to confirm that she did not have an infection. Others in government were not so fortunate: The state agriculture minister, Adam Marshall, said that he had tested positive after dining with three government colleagues on Monday at a Sydney restaurant.

Dr. Nicholas Talley, an epidemiologist at the University of Newcastle, said that the latest outbreak showed both the strength of contact tracing in New South Wales and the need to do more than rely on the same system of restrictions and tracing that worked earlier in the pandemic. The new variants, he said, required a new level of urgency from lawmakers.

“They need to look at the policy settings and give a jolt to the vaccine rollout,” he said. “Without generalized vaccination, and if the Delta variant gets hold, it can really be dangerous.”

A Secret Service agent on duty while former President Trump held a campaign rally in Oshkosh, Wis., last August.Credit…Doug Mills/The New York TimesThe rigors of protecting a president, a vice president and their families in an election year amid a pandemic placed a heavy burden on the Secret Service, with nearly 900 employees testing positive for the coronavirus, a watchdog group said this week.

The group, the Citizens for Responsibility and Ethics in Washington, faulted former President Donald J. Trump for continuing to hold large campaign rallies, which it said had contributed to the infections.

It obtained the Secret Service data from the federal government as part of a public records request under the Freedom of Information Act. The cases were recorded from March 2020 to March of this year, according to the group, but the data did not include details of the assignments of the agents who were infected. The government also did not disclose what percentage of the total number of Secret Service employees had contracted the virus.

The employees who tested positive included 477 special agents, 249 members of the uniformed division and 131 staff members working in administrative, professional and technical positions, according to the group. The Secret Service is the main federal law enforcement agency charged with protecting U.S. political leaders, including the president, and the families.

“Throughout the pandemic, then-President and Vice President Trump and Pence held large-scale rallies against public health guidelines, and Trump and his family made repeated protected trips to Trump-branded properties which the then-president was making millions of dollars a year from,” the group said on Tuesday in a post on its website. The group also blamed the former president for riding in a vehicle with Secret Service protection while he was under treatment for a coronavirus infection last October, “further putting agents in danger,” it said.

Representatives for Mr. Trump did not immediately respond to a request for comment on Wednesday night.

A spokeswoman for the Secret Service said in an emailed statement on Wednesday that the agency had distributed masks, gloves and other protective gear to employees and conducted a robust virus-testing program. She added that the agency’s mission “required significant public interaction during a public health crisis” and that it “was fully prepared and staffed to successfully meet these challenges.”

Last November, the Secret Service’s uniformed-officer division experienced a coronavirus outbreak, according to several people who were briefed on the matter at the time. The outbreak was at least the fourth to strike the agency since the pandemic began, with at least 30 uniformed Secret Service officers testing positive for the virus over several weeks. About 60 officers had been asked by the agency to go into quarantine.

In the final months of Mr. Trump’s presidency, the virus permeated the West Wing. Several of his top aides tested positive, including Hope Hicks, his adviser; Kayleigh McEnany, the White House press secretary; and two of Ms. McEnany’s deputies, Chad Gilmartin and Karoline Leavitt.

Mr. Trump, who had eschewed wearing masks for months, was sicker with Covid-19 last October than the White House publicly acknowledged at the time, according to several people familiar with his condition. At the time that he was hospitalized, his blood oxygen levels had plunged and officials feared he was on the verge of being placed on a ventilator.

A coronavirus quarantine center in Aden, Yemen.Credit…Fawaz Salman/ReutersFears that the pandemic has widened the divide between rich and poor nations have prompted a substantial effort at the International Monetary Fund to close the gap.

Under a proposal nearing completion, the I.M.F. would issue $650 billion worth of reserve funds, essentially creating money that troubled countries could use to purchase vaccines, finance health care and pay down debt.

Such a step would deliver “potentially the largest capital allocation since the end of World War II,” the administrator of the United Nations Development Program, Achim Steiner, declared this week.

But experts say that for poor countries to truly benefit, wealthy nations must voluntarily transfer some of their holdings to them — a course that I.M.F. officials are seeking to bring about.

A vaccination at Großhadern Hospital in Munich in March. Germany’s government revealed that Chancellor Angela Merkel had received two different shots, adding to growing interest in vaccine mixing.Credit…Laetitia Vancon for The New York TimesThe most widely used coronavirus vaccines are designed as two-shot inoculations. Nearly everyone worldwide who has had two doses received the same vaccine both times.

But that is changing, as more countries are allowing — and even, in some cases, encouraging — mixed inoculations, with people receiving a first shot of one vaccine, then a second shot of a different one. On Tuesday, Germany’s government revealed that Chancellor Angela Merkel had received two different shots, adding to the growing interest in the practice.

Some nations have tried that approach out of necessity, when supplies of a particular vaccine ran short, or out of caution, when questions were raised about the safety of a shot after some people had already received their first doses. U.S. regulators so far have been reluctant to encourage the practice.

But scientists and health policymakers are interested in the possibility that giving different shots to the same person could have significant advantages.

— Emily Anthes

Most of New York’s remaining pandemic restrictions were relaxed last week.Credit…Calla Kessler for The New York TimesNew York’s state of emergency will end on Thursday, Gov. Andrew M. Cuomo said on Wednesday. And with it will depart the freedom restaurants and bars have had to deliver and sell alcoholic beverages to go.

The official end of the state of emergency comes just over a week after Mr. Cuomo relaxed most of the state’s remaining restrictions, a welcome sign of the state’s steady march back toward normalcy after more than 53,000 deaths linked to the virus. The sudden halt to the freer sale of alcohol may be a boon to liquor stores while surprising the bars and restaurants that came to rely on the business they generated to weather the pandemic.

“The Legislature failed to codify the ability of restaurants to offer alcohol to-go,” New York State’s Liquor Authority said in an emailed statement, referring to legislation to extend the takeout alcohol that state lawmakers did not act on before their session ended this month. “With the state’s declaration of emergency expiring on Thursday, all temporary pandemic-related suspensions and directives, including privileges allowing bars, restaurants, and manufacturers to sell drinks to go, will end after June 24th.”

(Bill Crowley, a spokesman for the authority, noted that bars and restaurants could still deliver and sell beer to go, as they could before the pandemic.)

The Distilled Spirits Council, a trade association that has lobbied to keep to-go alcohol sales, said that 15 states had passed bills to make them permanent and that 12 had extended the period for such sales.

Lisa Hawkins, an official with the council, expressed dismay that New York was ending the practice. “It’s shocking and extremely disappointing that this important revenue stream will soon dry up for New York’s hospitality businesses,” she said in an email.

Andrew Rigie, the executive director of the New York City Hospitality Alliance, an association representing restaurants, bars and nightclubs, said that many proprietors had thought takeout alcohol would be allowed at least through July 5, when the latest in a series of extensions of the authorization for freer sales was set to expire.

Customers who have grown accustomed to the convenience of takeout tequila, delivery daiquiris and walkaway wine could also be taken aback, Mr. Rigie said in an interview. “It’s a shame the state legislature failed to continue to support local restaurants and to continue to deliver a very popular policy to New Yorkers,” he said.

But with restaurants and bars once again open to full capacity and more than 70 percent of adults in the state having received at least one dose of a vaccine, some New York City restaurateurs welcomed the change, which they hope will further motivate customers to spend time and money on premises.

“I want people to now come in, order food and enjoy the venue,” said Michael Trenk, managing partner of the Baylander Steel Beach bar and restaurant, located on a decommissioned aircraft carrier docked at the West Harlem Piers. “I don’t want you to just come in, buy a drink and leave.”

Mr. Cuomo declared the state of emergency on March 7, 2020, as New York City became one of the world’s hardest-hit places. In mid-March, when he limited restaurants and bars to takeout and delivery, the New York State Liquor Authority granted “new off-premises privileges,” meaning drinks to go.

Virus numbers declined in the city by the fall, but the state experienced a new surge in cases around the holidays and until relatively recently was still reporting new cases at a high rate. Buffalo and other cities also struggled to tamp down outbreaks. Vaccinations have helped radically improve the state’s caseload trajectory.

At a news conference on Wednesday, Mr. Cuomo said: “The emergency is over. It’s a new chapter.”

He said that federal guidance advising people to go on wearing masks in many situations if they are unvaccinated, and on public transportation and in settings like homeless shelters even if they are vaccinated, would remain in effect and that state and local health departments would be able to ensure that precautions were adhered to. He asked New Yorkers to remain “wary and vigilant” about the virus and noted that many still needed to be vaccinated, especially young people.

A colored transmission electron micrograph of a type of coronavirus.Credit…Sercomi/Science SourceResearchers have found evidence that a coronavirus epidemic swept East Asia some 20,000 years ago and was devastating enough to leave an evolutionary imprint on the DNA of people alive today.

The new study suggests that an ancient coronavirus plagued the region for many years, researchers say, and the finding could mean there are dire implications for the Covid-19 pandemic if it’s not brought under control soon through vaccination.

“It should make us worry,” said David Enard, an evolutionary biologist at the University of Arizona who led the study, which was published on Thursday in the journal Current Biology. “What is going on right now might be going on for generations and generations.”

Until now, researchers could not look back very far into the history of this family of pathogens. Over the past 20 years, three coronaviruses have adapted to infect humans and cause severe respiratory disease: Covid-19, SARS and MERS. Studies on each of these coronaviruses indicate that they jumped into our species from bats or other mammals.

Dr. Enard and his colleagues applied a new method to the search. Instead of looking at the genes of the coronaviruses, the researchers looked at the effects on the DNA of their human hosts.

He and his colleagues compared the DNA of thousands of people across 26 different populations around the world, looking at a combination of genes known to be crucial for coronaviruses but not other kinds of pathogens. In East Asian populations, the scientists found that 42 of these genes had a dominant version. That was a strong signal that people in East Asia had adapted to an ancient coronavirus.

They estimated that all of those genes evolved their antiviral mutations sometime between 20,000 and 25,000 years ago, most likely over the course of a few centuries. It’s a surprising finding, since East Asians at the time were not living in dense communities but instead formed small bands of hunter-gatherers.

Gov. John Bel Edwards of Louisiana and his wife, Donna Edwards, at a news conference last week announcing cash prizes and scholarships to encourage vaccination.Credit…Hilary Scheinuk/The Advocate, via Associated PressLike many states in the South, Louisiana’s vaccination rate has lagged significantly behind the national average, particularly among older adults, a trend that has troubled public health officials.

Some 22 percent of adults 65 and older still have not been vaccinated, compared with 12 percent nationally, according to a New York Times database. Just 34 percent of the state’s population has been fully vaccinated, compared with 46 percent nationally.

Louisiana is one of the latest states to resort to dangling financial incentives to get more shots into arms, a strategy that has kindled a broader debate over the effectiveness and wisdom of monetary enticements. It is holding a lottery, which will be paid for with federal coronavirus relief funds.

At the lottery’s unveiling last week, a jazz band played the state song, “You Are My Sunshine,” and Louisiana’s governor, John Bel Edwards, revealed a giant check for $1 million.

Mr. Edwards said amid the festivities that the money would go to a Louisiana adult who had received at least one dose of a Covid-19 vaccine. He said that the state would give away a total of $2.3 million in cash prizes and scholarships over a month. Registration for the lottery — marketed as “Shot at a Million” — began this week.

“Before launching our own program, we wanted to see how well it worked in other states, and, quite frankly, we’ve been impressed by the success that they’ve had,” Mr. Edwards said in announcing the lottery.

Louisiana’s vaccination rate, as a share of its population, is lower than every state but Mississippi. Six of the bottom eight states are in the South: They include Alabama, Arkansas, Georgia and Tennessee.

The Biden administration has made a concerted push to overcome vaccine hesitancy, particularly in the South. This week, the first lady, Jill Biden, visited Tennessee and Mississippi to encourage people to get vaccinated, while President Biden visited a mobile vaccination site in North Carolina on Thursday.

Gov. Mike DeWine of Ohio announced in May that five people would each win $1 million; the last winners were announced on Wednesday. On Thursday, Mr. DeWine said the state would focus on smaller incentives, like $25 DoorDash gift cards at select locations, and on expanding outreach and access to shots.

“We want our people to be protected,” Mr. Edwards said. “This is the way that we accomplish that. It is the way we can make sure that we return to normalcy and are able to safely gather.”

Dr. A. Mark Fendrick, the director of the University of Michigan Center for Value-Based Insurance Design, said in an interview that there was a compelling case for conducting lotteries but that they should be open only to people who were fully vaccinated.

“The people that we need to reach to get vaccinated, independent of their political affiliation, have been shown to be those populations who are likely to buy lottery tickets,” he said.

Dr. Fendrick, a primary-care physician who has studied consumer incentives for health care behavior for three decades, said it was too early to determine the effectiveness of the lotteries. In some states, he said, the lotteries coincided with making the vaccine available to teenagers, which could skew the numbers. He suggested comparing the vaccination rates in states with lotteries to those without them.

“I really want to see Michigan versus Ohio,” he said.

On Wednesday, North Carolina held its first lottery drawing as part of a similar vaccination push. Every other week, it will give away $1 million and a $125,000 scholarship to an adult and a teenager who get the vaccine.

Similar initiatives have been promoted by California, Illinois, Maryland, New Mexico and Washington.

In Oregon, however, the pace of vaccinations slipped since May, when Gov. Kate Brown announced a $1 million giveaway, The Oregonian reported this month.

Charles Boyle, a spokesman for Ms. Brown, said in an email on Tuesday night that the drop-off in vaccinations was to be expected as more residents had the shot. Oregon, he said, needed to inoculate less than 42,000 people to reach its target of at least 70 percent of adults having received at least one shot.

Mr. Boyle said that the “Take Your Shot, Oregon” campaign was part of a broader strategy that included using more and smaller vaccine clinics to lift the vaccination rate.

“No individual strategy is expected to have a singularly massive impact or to wholly reverse vaccination rate trends,” he said. “Each strategy adds a little energy to the overall effort.”

Daniel E. Slotnik contributed reporting.

Correction: June 25, 2021

Because of an editing error, an earlier version of this article misstated the date of North Carolina’s first vaccination lottery drawing. It was June 23, not June 30.

Dr. Anthony S. Fauci, right, and Mayor Muriel E. Bowser of Washington, center, went door-knocking in the city’s Anacostia neighborhood on Saturday to encourage residents to get vaccinated.Credit…Kenny Holston for The New York TimesResearchers at the University of Washington on Thursday unveiled a new interactive map that charts attitudes toward coronavirus vaccination by ZIP code, a tool that will allow state and local health officials to conduct highly targeted vaccine drives.

The nation has about 3,000 counties, but roughly 30,000 ZIP codes. Most health departments track vaccination rates by county and do not track vaccine hesitancy.

The new map, a joint project between the university’s Institute of Health Metrics and Evaluation and the nonprofit Covid Collaborative, relies on online surveys that show striking variations in attitudes even within counties.

In rural Minnesota, for example, 67 percent of people polled on Facebook in the ZIP code 56350 said they were unlikely to get vaccinated or had definitely decided not to get the shots. In the adjacent ZIP code, 55760, the number dipped to 9 percent.

Both ZIP codes are within Aitkin County, where the map shows that 14 percent of people who answered the survey are either hesitant or say they will not be vaccinated.

The map is coming online just as the Biden administration’s vaccination drive is shifting away from mass vaccination sites and toward what officials are calling “the ground game”: a labor-intensive effort that in many states will involve door-knocking campaigns of the sort that politicians use to get out the vote.

The White House publicly acknowledged this week that it will not reach President Biden’s goal of having 70 percent of American adults at least partially vaccinated by July 4. If the rate of adult vaccinations continues on the current seven-day average, the country will come in just shy of his target, with about 67 percent of adults having at least one shot by July 4, according to a New York Times analysis.

The newly published map relies on research conducted by the Carnegie Mellon University’s Delphi Research Group, with support from Facebook. Each day, researchers ask a random sample of 50,000 Facebook users the following question: “If a vaccine to prevent Covid-19 were offered to you today, would you choose to get vaccinated?” There are three possible answers: Yes, Probably or No.

The data will be updated every two weeks, said Dr. Christopher Murray, director of the health metrics institute. He said Facebook does not have access to the data. His group has been working on the project since mid-May.

John Bridgeland, a founder of the Covid Collaborative, said its creators are considering the project a “beta test” and are soliciting feedback from health officials who use it. It identifies counties and ZIP codes on a red-blue spectrum from dark red to dark blue, with dark red signifying the most hesitant and dark blue signifying the least.

“If you think about transmission like a fire, if you concentrate all the kindling in one place, you’re going to get a fire there,” Dr. Murray said. “If we don’t solve this hesitancy problem, especially in communities that are light blue to red, we will see a winter surge in some of those places.”

Lazaro Gamio contributed reporting.