Covid-19: Birx Lashes Trump’s Pandemic Response and Says Deaths Could Have Been ‘Decreased Substantially’

Trump’s former pandemic coordinator suggests that a restrained response may have cost hundreds of thousands of lives.

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Former President Donald J. Trump and former Vice President Mike Pence with Adm. Brett P. Giroir and Dr. Deborah Birx during a news conference at the White House in April 2020.Credit...Doug Mills/The New York Times

In interviews broadcast on CNN Sunday night, former President Donald J. Trump’s pandemic officials confirmed in stark and no uncertain terms what was already an open secret in Washington: The administration’s pandemic response was riddled with dysfunction, and the discord, untruths and infighting most likely cost many lives.

Dr. Deborah L. Birx, Mr. Trump’s coronavirus response coordinator, suggested that hundreds of thousands of Americans may have died needlessly, and Adm. Brett P. Giroir, the testing czar, said the administration had lied to the public about the availability of testing.

The comments were among a string of bombshells that emerged during a CNN special report that featured the doctors who led the government’s coronavirus response in 2020.

Dr. Robert R. Redfield, the former director of the Centers for Disease Control and Prevention, accused Mr. Trump’s health secretary, Alex M. Azar III, and the secretary’s leadership team of pressuring him to revise scientific reports. “Now he may deny that, but it’s true,” Dr. Redfield said in an interview with Dr. Sanjay Gupta, CNN’s chief medical correspondent. Mr. Azar, in a statement, denied it.

Dr. Stephen K. Hahn, the former commissioner of the Food and Drug Administration, said his relationship with Mr. Azar had grown “strained” after the health secretary revoked the agency’s power to regulate coronavirus tests. “That was a line in the sand for me,” Dr. Hahn said. When Dr. Gupta asked him if Mr. Azar had screamed at him, Dr. Hahn replied: “You should ask him that question.”

But it was Dr. Birx, who has been pilloried for praising Mr. Trump as being “so attentive to the scientific literature” and for not publicly correcting the president as he made outlandish claims about unproven therapies, whose disclosures may have been the most compelling.

As of Sunday, more than 548,000 Americans have died from infection with the coronavirus. “I look at it this way,” she said. “The first time, we have an excuse. There were about 100,000 deaths that came from that original surge.”

“All of the rest of them,” she said, referring to almost 450,000 deaths, “in my mind, could have been mitigated or decreased substantially” had the administration acted more aggressively.

In what was one of her first televised interviews since leaving the White House in January, she also described a “very uncomfortable, very direct and very difficult” phone call with Mr. Trump after she spoke out about the dangers of the virus last summer. “Everybody in the White House was upset with that interview,” she said.

After that, she decided to travel the country to talk to state and local leaders about masks and social distancing and other public health measures that the president didn’t want her to explain to the American public from the White House podium.

Dr. Gupta asked if she was being censored. “Clearly someone was blocking me from doing it,” she said. “My understanding was I could not be national because the president might see it.”

Several of the officials in the interview, including Dr. Anthony S. Fauci — who unlike the others is a career scientist and is now advising President Biden — blamed China, where the virus was first detected, for not being open enough with the United States. And several, including Dr. Redfield and Admiral Giroir, said early stumbles with testing — and the attitude within the White House that testing made the president look bad by driving up the number of case reports — were a serious problem in the administration’s response.

And the problems with testing went beyond Mr. Trump’s obsession with optics. Admiral Giroir said that the administration simply did not have as many tests as top officials claimed at the time.

“When we said there were millions of tests — there weren’t, right?” he said. “There were components of the test available but not the full deal.”

In a lengthy statement Monday evening, Mr. Trump shot back at Dr. Fauci and Dr. Birx, blasting them as “two self-promoters trying to reinvent history to cover for their bad instincts and faulty recommendations,” while praising his administration’s efforts to develop a vaccine.

The former president, who routinely questioned the need for lockdowns and other precautions during his administration, said of Dr. Fauci and Dr. Birx, “If it were up to them, we’d currently be locked in our basements as our country suffered through a financial depression.”

Cases in Florida, a national Covid bellwether, are rising — especially among younger people.

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A scene from the resort island of South Beach last week. Credit...Calla Kessler for The New York Times

Scientists view Florida — the state furthest along in lifting restrictions, reopening society and welcoming tourists — as a bellwether for the nation.

If recent trends there are any indication, the rest of the country may be in trouble.

The number of confirmed coronavirus cases in Florida has been steadily rising, though hospitalizations and deaths are still down. Over the past week, the state has averaged nearly 5,000 cases per day, an increase of 8 percent from its average two weeks earlier.

B.1.1.7, the more contagious variant first identified in Britain, is also rising exponentially in Florida, where it accounts for a greater proportion of total cases than in any other state, according to numbers collected by the Centers for Disease Control and Prevention.

“Wherever we have exponential growth, we have the expectation of a surge in cases, and a surge in cases will lead to hospitalizations and deaths,” said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.

Florida has had one of the country’s most confusing and inefficient vaccination campaigns, and has fully vaccinated about 15 percent of its population — well below what top states, like New Mexico and South Dakota, have managed. Still, immunization of older people and other high-risk individuals may blunt the number of Florida’s deaths somewhat. The state has announced it will start offering the vaccine to anyone over age 18 on April 5.

At least some of the cases in Florida are the result of the state’s open invitation to tourists. Hordes of students on spring break have descended on the state since mid-February. Rowdy crowds on Miami Beach this month forced officials to impose an 8 p.m. curfew, although many people still flouted the rules.

Miami-Dade County, which includes Miami Beach, has experienced one of the nation’s worst outbreaks, and continues to record high numbers. The county averaged more than 1,100 cases per day over the past week.

In Orange County, cases are on the rise among young people. People 45 and younger account for one in three hospitalizations for Covid, and the average age for new infections has dropped to 30.

Gov. Ron DeSantis has rejected stringent restrictions from the very start of the pandemic. Florida has never had a mask mandate, and in September Mr. DeSantis banned local governments from enforcing mandates of their own. Among his scientific advisers now are architects of the Great Barrington Declaration, which called for political leaders to allow the coronavirus to spread naturally among young people, while the elderly and those with underlying conditions sheltered in place.

Tracking the Coronavirus ›

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In the U.S., cases tick upward again as variants spread and states lift restrictions.

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People waiting for coronavirus tests in Corona, Queens, N.Y., last week. The state’s seven-day average of new infections has shot up by more than 3,000 since last Tuesday.Credit...James Estrin/The New York Times

After weeks of decline followed by a steady plateau, coronavirus cases are rising again in the United States. Deaths are still decreasing, but the country averaged 61,545 cases last week, 11 percent more than the average two weeks earlier.

Scientists predicted weeks ago that the number of infections would curve upward again in late March, at least in part because of the rise of variants of the coronavirus across the country. The variant that walloped Britain, called B.1.1.7, has led to a new wave of cases across most of Europe. Some scientists warned that it may lead to a new wave in the United States.

The rise in infections is also a result of state leaders pulling back on mitigation measures, and large social interactions, like spring break gatherings in Florida, Dr. Anthony S. Fauci, the Biden administration’s chief science adviser, said on the CBS program “Face the Nation” on Sunday.

“The variants are playing a part, but it’s not completely the variants,” Dr. Fauci said. Most states have lifted restrictions, including on indoor dining, in response to the drop in numbers, actions that Dr. Fauci called “premature.”

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As of Thursday, there were 8,337 known cases of the B.1.1.7 variant in the country, but the actual number is probably much higher because labs in the country analyze only a very small proportion of the diagnosed cases. Still, the trend is clear: The variant — which is more transmissible and possibly more lethal — has been rising exponentially in the United States, its growth masked by the overall drop in infections.

“It is remarkable how much this recalls the situation last year where we had introductions of virus to different places that scientists warned would be a problem,” Bill Hanage, an epidemiologist at the Harvard T.H. School of Public Health, said in an interview on Sunday. “People waited for them to be a problem before they took action — and then too late, they took action.”

Dr. Hanage said he was particularly worried about B.1.1.7 because it is at least 50 percent more transmissible than the original virus. The brisk pace of vaccinations will stem the tide somewhat, but the rising immunity in the population may be more than offset by the variant’s contagiousness, he added. “B.1.1.7 is really scary,” he said.

The vaccines in use in the United States — made by Pfizer-BioNTech, Moderna and Johnson & Johnson — are expected to prevent severe disease and death from any of the variants, although they are slightly less effective against a variant that was identified in South Africa. That variant, known as B.1.351, has not yet spread widely in the United States.

Because many of the highest-risk people have been inoculated, hospitalizations and deaths may not show a steep rise along with infections. But a surge in cases will still lead to some severe cases and deaths, Dr. Hanage said.

“How large it will be we’ll need to wait and see,” he said. “But ideally we would not be waiting to see, ideally we’d be taking action.”

As vaccine rollout gathers pace, Israelis celebrate Passover together.

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Ultra-Orthodox Jewish men and children burning leavened items in final preparation for the Passover holiday in Bnei Brak, near Tel Aviv, on Friday. Gatherings in Israel are now possible as more than half of the country’s population has been vaccinated.Credit...Oded Balilty/Associated Press

This time last year, Esti Shushan’s Passover was ruined. The sudden enforcement of the coronavirus lockdown in Israel forced Ms. Shushan to mark the Jewish festival — usually a joyous time of large family gatherings — with just her four children and husband.

But this weekend, Ms. Shushan, an entrepreneur and women’s rights activist, was able to return to something approaching normality. Israel’s vaccine program has caused infection rates to plummet, leading to a loosening of restrictions. Ms. Shushan gathered on Saturday night with 40 relatives.

“It was a feeling of release,” she said. “It made us feel free. It allowed us to breathe — to experience the springtime around us.”

Across Israel, life is opening up. More than half of the Israeli population has received both doses of the Pfizer-BioNTech vaccine, the highest rate in the world.

On Saturday evening, that allowed large groups to celebrate Passover, which marks the escape of Israelites from slavery in Egypt. Then on Sunday morning, Christian worshipers were permitted to gather in large numbers to mark Palm Sunday — including at the Church of the Holy Sepulchre, which according to tradition was built on the site in Jerusalem where Jesus Christ was both crucified and buried.

For many Israelis, the emergence from anti-virus restrictions gave added symbolism to a ritual, known in Judaism as Seder, that centers on freedom.

“For Jews, Seder is celebrating liberation,” said Harry D. Wall, an activist and documentary filmmaker who celebrated the evening in a group of 11 in Jerusalem — 10 more than last year when he spent the holiday alone.

“And that made the return to in-person gathering, after a year of on-off lockdowns, restrictions, isolation from friends and family to be even more meaningful this year,” Mr. Wall added. “It felt like a real deliverance.”

The atmosphere at the Palm Sunday service at the Church of the Holy Sepulchre — where worshipers commemorated Christ’s entry into Jerusalem, a week before his crucifixion — was still subdued compared with the prepandemic era. Most places of worship can still admit only up to 50 percent of their capacity. But it was a happy improvement from last year, said Pierbattista Pizzaballa, the most senior Catholic official in the city.

“Last year was a terrible Easter, without people, closed doors,” he said in an interview with Reuters after the service. “This year is much better — the doors are open. We don’t have a lot of people, but we feel more hopeful that things will become better.”

A few miles to the south in Bethlehem, in the occupied West Bank, Christian Palestinians were also able to gather at the Church of the Nativity, which stands on a site where tradition holds that Christ was born. But the mood in Bethlehem is generally more somber: As in much of the West Bank, the city now shuts down at 7 p.m. to help temper the spread of the virus.

The infection rate is surging in the parts of the occupied territories administered by the Palestinian Authority. The authority has been able to procure only a small fraction of the vaccines it needs to protect the Palestinian population. And Israel has vaccinated predominantly those Palestinians who work in Israel itself or in Jewish settlements in the West Bank, stirring a debate about its responsibility as an occupying power.

Israel argues that Palestinian officials assumed responsibility for vaccinations after the signing of the Oslo accords in the 1990s. But Palestinian advocates argue it is Israel’s duty to help the Palestinians, citing the Fourth Geneva Convention, an international law that governs occupations.

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New York becomes the first state to offer a Covid-19 vaccination digital pass.

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The new Excelsior Pass app, which people in New York State can download to show proof of vaccination or a negative coronavirus test.Credit...NY Governor's Press Office, via Associated Press

New York State has introduced a digital app that allows individuals to prove they have been fully vaccinated against the coronavirus or have recently tested negative, as part of an effort to fast-track the reopening of businesses, sports arenas and entertainment venues in the state.

New York is the first state to formally create a digital passport for Covid-19. The free online platform, called Excelsior Pass, was developed with IBM and works like a mobile airline boarding pass. Users are assigned a digital pass with a secure QR code, which they can print out or save to their smartphones. Participating businesses then use a companion app to scan the customer’s QR code and verify their Covid status. The state said people’s data would be kept secure and confidential.

“The question of ‘public health or the economy’ has always been a false choice — the answer must be both,” Gov. Andrew M. Cuomo said in a statement. “As more New Yorkers get vaccinated each day and as key public health metrics continue to regularly reach their lowest rates in months, the first-in-the-nation Excelsior Pass heralds the next step in our thoughtful, science-based reopening.”

The Biden administration has been monitoring private and nonprofit efforts to develop vaccine passports, and is working to ensure that they meet certain standards, including for privacy, Jeffrey D. Zients, the White House coronavirus response coordinator, told reporters this month.

“As we increase the number of people vaccinated, we know some people may have a need to demonstrate that they are vaccinated,” Mr. Zients said. “The private sector and not-for-profit coalitions are already beginning to work on this. Our role is to help ensure that any solutions in this area should be simple, free, open source, accessible to people both digitally and on paper, and designed from the start to protect people’s privacy.”

As part of the initial launch, New Yorkers can use the digital pass to verify their Covid-19 status to attend games at stadiums and arenas, wedding receptions or other events above the state’s social gathering limit.

Major venues, including the 20,000-seat Madison Square Garden in New York City, have announced they plan to use this technology in the coming weeks. Beginning April 2, smaller arts and entertainment venues can also use Excelsior Pass. Interested New Yorkers can sign up for the app here.

The Centers for Disease Control and Prevention recently released its guidance for people in the United States who have been fully vaccinated, which is two weeks after the second dose in the Pfizer-BioNTech or Moderna vaccine or two weeks after the one-dose Johnson & Johnson vaccine.

It allows for the resumption of some activities in private settings between fully vaccinated people in small groups or a fully vaccinated household with one other unvaccinated household. It emphasized how fully vaccinated people should keep following health and safety precautions in public, including wearing a mask.

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Paris doctors warn that hospitals may be overwhelmed as cases surge anew.

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The intensive care unit at the Melun-Senart hospital, near Paris, earlier this month.Credit...Benoit Tessier/Reuters

Doctors in the Paris region warned Sunday that hospitals there may soon be overwhelmed with coronavirus cases as a third wave of the pandemic sweeps through the country, possibly forcing them to choose which patients they will treat.

In an op-ed article published in the Journal du Dimanche newspaper, 41 doctors said that vaccinations were not being administered fast enough, creating a “catastrophic medical situation” in which Paris region hospital capacity will be exceeded in the next two weeks.

“We have never experienced such a situation, even during the worst attacks in recent years,” the doctors wrote, referring to the attacks by Islamic State terrorists in Paris in 2015 that killed 130 people.

“We will be forced to triage patients in order to save as many lives as possible,” the doctors added, saying that the emergency would lead to “non-access of care” for some patients.

The warning comes as the number of Covid patients in intensive care in France hit 4,900, nearly the same level as a year ago, when the pandemic first surged into the country. The rise now is linked to the rapid spread of the variant first discovered in Britain. France has lagged behind other European countries in its vaccine rollout.

In an interview published Sunday in the same newspaper, President Emmanuel Macron defended a recent decision not to fully lock down the country despite the alarming surge.

The government recently imposed a nationwide curfew of 7 p.m. and closed nonessential businesses. But on Sunday, a warm sunny afternoon, crowds of people in Paris jammed the quais along the Seine river and thronged to parks, some not wearing masks while drinking and eating, prompting warnings from police officers patrolling the streets.

Mr. Macron, in the newspaper interview, left open the possibility of shifting course should hospitals face the threat of being overwhelmed.

“The coming weeks will be difficult,” he said. “We will take all the necessary measures in due time, and in my view, there is no taboo.”

In other news around the world:

  • In Germany, Chancellor Angela Merkel warned of potential curfews as case rates continue to climb. The country’s vaccination rate — 10 percent of the population has received at least a first shot, according to a New York Times database — is behind other nations in Europe and around the world.

  • Britain, where at least 45 percent of the country is partly vaccinated, is set to lift at least two lockdown measures. As of Monday, up to six people, or two households, can gather outside; and outdoor sports sites, like tennis courts and basketball courts, can be used to a limited degree.

  • In Australia, the city of Brisbane announced a three-day lockdown after seven people were infected with the coronavirus, the first citywide lockdown in the country in more than a month. Starting at 5 p.m. on Monday, residents of Australia’s third-largest city will be allowed to leave their houses only for essential purposes — such as buying groceries, exercising or seeking medical care — and masks will be mandatory in public. Tests showed the virus spreading in Brisbane is the highly contagious variant first detected in Britain, officials said.

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Six states are opening vaccination to all adults on Monday, with many residents eager for shots.

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A vaccination site at Cleveland State University in Ohio was expected to administer 6,000 shots a day shortly after it opened earlier this month. The state is among those expanding vaccinations to all adults.Credit...Joshua Gunter/The Plain Dealer, via Associated Press

Chris Adams, 36, has spent the past year of the pandemic living with his grandparents in Wichita, Kan., and being “extremely strict” about social distancing. “I never went out,” he said.

But starting Monday, when all adults in Kansas become eligible for the coronavirus vaccine, Mr. Adams plans to find a vaccination site where there is an available appointment. “What I’m looking forward to is seeing my friends again,” he said.

Kansas is one of six states — Louisiana, North Dakota, Ohio, Oklahoma and Texas are the others — that are expanding eligibility for the vaccine to all adults on Monday. Minnesota will follow on Tuesday, and Indiana and South Carolina on Wednesday.

Gov. Laura Kelly of Kansas urged residents last week to seek out appointments, saying, “With the anticipated increase in supply from the federal government, we must get every dose of vaccine into arms quickly.”

Even as vaccine eligibility continues to expand across America — nearly all states have pledged to make every adult eligible by May 1 — the United States has also reported an increase in new cases over the past week. About 75,000 new cases were reported on Friday, a significant increase from the 60,000 added the Friday before.

States in the Northeast have accounted for about 30 percent of the nation’s new cases over the past two weeks, up from 20 percent in the first couple of weeks in February.

In New York, there has been an average of 8,426 new cases a day, an 18 percent increase from the average two weeks earlier, according to a New York Times database. In New Jersey over the past week, there have been an average of 4,249 new cases reported daily, a 21 percent increase from the average two weeks earlier. And on Friday, Vermont set a single-day case record with 283 new infections; it is the first state to set a case record since Jan. 18.

For many, the vaccine cannot come soon enough.

Nicole Drum, 42, a writer in the Kansas City, Kan., metro area, cried on Friday when she found out that she would be eligible to get the vaccine as early as Monday. She started calling pharmacies and looking online for available appointments “within minutes of the news breaking,” she said.

Ms. Drum called about 10 places without success. She had more luck on a county website, and booked an appointment for Wednesday.

She said she planned to wear a special T-shirt saying “I believe in science” to her appointment. “I got myself a fun I’m-getting-the-vaccine outfit,” she said, laughing.

She also plans to take her 4-year-old son with her, because she wants him to see “how research and science and people coming together can really help stem these kinds of things,” she said.

“I want him to know that there’s no need to be afraid all the time of big scary things, because there are always helpers trying to figure this out,” Ms. Drum said. “While the solution might be something that’s a jab in the arm that hurts a little bit, it’s worth it.”

A concert in Barcelona for 5,000 is Europe’s latest experiment in live events.

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Thousands Attend Experimental Indoor Concert in Barcelona

A concert for 5,000 people was held at a Barcelona arena on Saturday, one of several planned in Europe to test how crowds can gather safely during the pandemic. Attendees were screened for the coronavirus before the show.

[music] [applause]

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A concert for 5,000 people was held at a Barcelona arena on Saturday, one of several planned in Europe to test how crowds can gather safely during the pandemic. Attendees were screened for the coronavirus before the show.CreditCredit...Emilio Morenatti/Associated Press

BARCELONA, Spain — Mireia Serret, a 21-year old student at the University of Barcelona, said that she was not a big fan of the band that played here on Saturday, nor does she normally like large crowds.

Nevertheless, she snapped up one of the 5,000 tickets to Europe’s biggest indoor rock concert since the start of the pandemic. “It had just been too long since I was last able to dance and have fun at a concert,” she said.

Organized by a group of Spanish music promoters as part of an initiative called “Festivals for Safe Culture,” the concert in the Palau de Sant Jordi was presented as Europe’s boldest effort to get thousands into an indoor venue, without seating or mandatory social distancing. The sole act was Love of Lesbian, a Spanish indie rock band formed decades ago.

A hospital team helped test the concertgoers for the coronavirus beforehand. Six people tested positive, according to the organizers. The team is relying on public medical records to track whether any concertgoers later test positive.

At a time when countries like France and Italy have recently put their residents back under lockdown to help stop another wave of infection, the people behind the Barcelona event said their goal was to look ahead.

Such trial events have been held in several European countries, including in Germany and the Netherlands. The British government will run a series of test events next month, including one at a nightclub in Liverpool.

Europe’s famed summer music festivals are in doubt again this year. Several festivals have already canceled their June lineups, including Rock am Ring at the Nürburgring racetrack in Germany and Sonar festival in Barcelona.

Still, Roskilde, Denmark’s biggest festival, hopes to go on in June with acts including the rapper Kendrick Lamar. The Danish government said last week that it aims to restart pop concerts starting May 6 with the help of a “corona passport” that will allow people to show their status of vaccination, proof of recent negative tests for the virus or documentation they have recovered from Covid-19.

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A volunteer army aims to vaccinate Black people in the rural South.

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Dorothy Oliver, who runs the General Store in Panola, Ala., population 144, making calls to residents this month to see if they have been vaccinated.Credit...Abdul Aziz for The New York Times

PANOLA, Ala. — A dog-eared trailer that serves as the only convenience store within 20 miles of this blink-and-you-miss-it rural hamlet, population 144, is more than a place to stock up on life’s essentials. These days the store — or more precisely its proprietor, Dorothy Oliver — has become an unofficial logistics hub for African-American residents seeking the coronavirus vaccine.

Even as vaccine supplies in Alabama have become more plentiful, Ms. Oliver’s neighbors, many of them older and poor, lack the smartphones and internet service needed to book appointments. And if they manage to secure a slot, they may not have a way to get to distant vaccination sites.

Ms. Oliver helps her neighbors snag appointments online and matches them with those willing to make the 45-minute drive to Livingston, the seat of Sumter County and the nearest town offering inoculations. Nearly three-quarters of the residents of the county, which includes Panola, are African-American.

“We’ve got to fend for ourselves because no one else is going to help us,” said Ms. Oliver, 68, a loquacious retired office administrator who spends many of her waking hours on the phone. “That’s the way it’s always been for poor Black people living in the country.”

Across the Southern states, Black doctors, Baptist preachers and respected community figures like Ms. Oliver are trying to combat lingering vaccine skepticism while also helping people overcome logistical hurdles that have led to a troubling disparity in vaccination rates between African-Americans and whites.

Though local leaders have made headway combating the hesitancy, they say the bigger obstacles are structural: the large stretches of Alabama and Mississippi without an internet connection or reliable cellphone service, the paucity of medical providers, and a medical establishment that has long overlooked the health care needs of African-Americans.

As Russia proudly exports its Sputnik V vaccine, it struggles to manufacture the vaccine domestically.

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A laboratory operated by the pharmaceutical company Biocad, a contractor for the site where the Sputnik V vaccine is produced, last month in St. Petersburg, Russia.Credit...Emile Ducke for The New York Times

MOSCOW — While Russia is exporting its homegrown Sputnik V coronavirus vaccine to countries in Latin America, Africa and Europe to great fanfare, it is quietly having to import supplies to meet its own demands, struggling to produce the vaccine at home and relying on overseas manufacturers.

The Russian government struck a deal with a South Korean company, GL Rapha, to make Sputnik V doses and ship them to Russia. Several planeloads arrived in December and another shipment is due soon.

The Kremlin has deals with companies in India to start doing the same, but those deals may be clouded by India’s recent moves to block vaccine supplies from export so that they can be used domestically.

Russia has highlighted its vaccines, led by Sputnik V, as a triumph of the country’s scientists, but manufacturing them domestically on a large scale has been a different story. Domestic producers struggled for months last fall to obtain the Chinese-made biotechnology equipment that they needed.

The exact scale of Russia’s imports has not been disclosed, but it is expected to grow in the next few months. Russian officials said last fall that overseas manufacturing could be used to meet domestic demand, but have since gone quiet on the matter.

The imported doses could help Russia overcome a dismally slow vaccination rollout at home. So far, Russia has vaccinated 4.4 percent of its population, compared with 10 percent in the European Union and 26 percent in the United States.

The situation also illustrates that even countries whose scientists have designed successful vaccines must often rely on cross-border trade for supplies.

The slow start to production even played a role in when President Vladimir V. Putin was inoculated. His spokesman said last week that Mr. Putin put off getting a shot in January, when he became eligible under Russia’s priority rules, to avoid stimulating demand before the vaccine became widely available outside Moscow.

Mr. Putin said last week that enough Sputnik V to fully inoculate 8.9 million people — out of a population of about 145 million — had been distributed in Russia since regulators approved the vaccine last August. Russia’s minister of industry said Monday that he expected the country to soon be producing twice that amount every month.

More than 20 countries have begun using Sputnik V in relatively small amounts provided by Russia, including Algeria, Argentina, Bolivia, Hungary and Paraguay. Russian officials have said that most of the demand for Sputnik V abroad will be met by overseas production.

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Facebook freezes Nicolás Maduro’s page for spreading virus misinformation.

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President Nicolás Maduro of Venezuela promoted an unproven remedy for Covid-19 on Facebook, which prompted the company to freeze his page. Credit...Manaure Quintero/Reuters

The Facebook page of Venezuela’s president, Nicolás Maduro, was frozen for “repeated” violations of its misinformation policies, including a post about an unproven remedy for Covid-19, the company said on Sunday, the latest example of the social media giant cracking down on political figures who violate its content policies.

Mr. Maduro’s Facebook page will be frozen for 30 days in a “read-only” mode, the company said, “due to repeated violations of our rules.”

“We removed a video posted to President Nicolas Maduro’s Page for violating our policies against misinformation about Covid-19 that is likely to put people at risk for harm,” a Facebook spokesman said. “We follow guidance from the W.H.O. that says there is currently no medication to cure the virus.” The spokesman was referring to the World Health Organization.

Facebook’s move came after Mr. Maduro posted a video on his page that promoted Carvativir, a drug derived from thyme. He said in January that the medicine was a “miracle,” but did not provide evidence of its effectiveness — and declined to release the name of the “brilliant Venezuelan mind” that created the drug. In the video, Mr. Maduro falsely claimed that Carvativir can be used preventively and therapeutically against the coronavirus.

In the past, Facebook has been criticized for its inaction against political figures who test the boundaries of the company’s content policies by spreading misinformation. Mark Zuckerberg, the founder and chief executive of Facebook, has said he does not want to be the “arbiter of truth” in public discourse.

But in recent months, Facebook has cracked down on certain types of misinformation across the network. The company has banned posts containing false or misleading information regarding the coronavirus, and has shown willingness to take action against some political figures. And in the past, it has removed at least one post by Jair Bolsonaro, the president of Brazil, for false coronavirus remedy claims regarding the malaria drug hydroxychloroquine.

In January, after insurgents stormed the United States Capitol, President Donald J. Trump’s account was banned indefinitely for inciting his supporters to violent action using the social network.

In response to his account restriction, Mr. Maduro has said Facebook is practicing a form of “digital totalitarianism,” according to Reuters, which first reported Mr. Maduro’s suspension.

Mr. Maduro said on Twitter on Sunday that he would continue to broadcast his regular coronavirus briefing from his other digital accounts, including Instagram, YouTube and Twitter. And to circumvent his suspension, he said he would use the Facebook account belonging to his wife, Cilia Flores, to broadcast Covid-19 information. Facebook would not comment on whether it would suspend Ms. Flores’s account.

Many U.S. graduations are curtailed again, but some commencements will go on without guests.

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Harvard graduates celebrating during their commencement last May.Credit...Cassandra Klos for The New York Times

Yale plans to hold a version of in-person graduation for the class of 2021 in May — with no guests allowed. Harvard is not even calling its commencement a “commencement.” It plans to hold virtual degree-granting ceremonies and, for the second year in a row, will postpone traditional festivities.

The universities of South Florida, Southern California, Pennsylvania, North Carolina at Chapel Hill, Vanderbilt, Rochester and Kentucky, among others, are holding in-person commencements, but with differing rules about guests.

So it goes in this second graduation season of the pandemic. Day by day, another university announces commencement plans, and given the uncertainty created by the coronavirus, the decisions are breaking in opposite ways.

Prairie View A&M in Texas plans to hold live commencements, even as, somewhat surreally, the president of the college, Ruth Simmons, will be delivering the principal address at Harvard’s virtual commencement.

In the United States, reported coronavirus cases and deaths have fallen significantly after a post-holiday surge, according to a New York Times database. Vaccinations have also picked up, averaging about 2.5 million shots a day, as eligibility expands in several states.

Who Is Eligible for Vaccines in Each State

People 16 and older are now eligible in every state. See more »

Age

16+

Restaurant workers

Yes

No

High-risk adults

Yes

No

Note: Data as recent as April 19.

Sources: State and county health departments

Experts warn, however, that dangerous variants could lead to a spike in cases and states that lift restrictions could be acting prematurely.

Many universities are stipulating that in order to participate in graduation, students must have tested negative for the coronavirus before the ceremony and have a good record of adhering to campus policies created to guard against infection.

Peter Salovey, the president of Yale, said in a statement this month that the university would be recognizing graduation by holding in-person gatherings “on or around May 24, if public health conditions permit.” Students studying both on campus and remotely are invited, but not their guests. Mr. Salovey said Yale was excluding families because it seemed unlikely that everybody would be vaccinated by graduation day.

Harvard was one of the first universities to evacuate its campus in mid-March last year, and it is still in caution mode. In an email to students on Feb. 26, its president, Lawrence Bacow, said that postponing live commencement for two years running was “deeply disappointing, but public health and safety must continue to take precedence.”

Like other universities, though, Harvard promised to bring the classes of 2020 and 2021 back to celebrate at some future date.

Some universities plan to hold their commencements in outdoor stadiums. Notre Dame, which was aggressive about bringing students back to campus last fall, is planning to accommodate all 3,000 graduates and a limited number of guests in its 79,000-seat stadium. Health officials have authorized the use of up to 20 percent of the seating.

The University of Southern California will hold in-person ceremonies for the classes of 2021 and 2020 in May. The ceremonies will take place at the Los Angeles Memorial Coliseum and graduates will be allowed to invite two guests, although they must be California residents.

Northeastern University in Boston will host five commencement ceremonies in Fenway Park in May. Officials are aiming to allow each graduate to invite one guest, though they are still evaluating total capacity with physical distancing.

The University of South Florida in Tampa said this month that its commencement would take place at nearby Tropicana Field, which can hold about 40,000 people. The university set a tentative date of May 7 to 9. Students will be allowed to bring two guests and must register in advance.

Some schools are holding ceremonies without guests, in what will be largely empty stadiums.

The University of Wisconsin-Madison will hold in-person ceremonies in its Camp Randall Stadium, which can hold about 80,000 people. The university will hold two ceremonies on May 8, but graduates cannot bring guests.

Princeton plans to hold an outdoor commencement at its stadium for students who have taken part in the testing program and who live on or near campus. It is also considering extending the invitation to students learning virtually.

Princeton is still deciding whether to allow guests at its in-person ceremony, and summed up the uncertainty this way: “Families are encouraged not to make nonrefundable travel arrangements.”

Some universities are moving forward with entirely virtual commencements. Columbia is planning a virtual ceremony, but has held out some hope of smaller outdoor events. New York University and Stanford University have also announced plans to hold virtual celebrations.

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At least 36 states give clergy vaccine priority, for the risks they face and the example they set.

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The Rev. Patricia Hailes Fears receiving the Johnson & Johnson vaccine during a gathering of interfaith clergy members, community leaders and officials at the National Cathedral in Washington this month.Credit...Manuel Balce Ceneta/Associated Press

At least 36 states have made some members of the clergy eligible for a vaccine before the rest of the population, according to a New York Times survey.

The vaccines come at a critical time: As religious leaders continue to work on the front lines of the pandemic in hospitals, mortuaries and long-term care facilities, many are now working with health officials to help combat vaccine hesitancy in their communities.

In Utah, mosques are sharing videos on social media of imams receiving the vaccine. In Michigan, a rabbi is weaving messages of support for vaccination into his sermons and conversations with his congregation. And at the Washington National Cathedral this month, Dr. Anthony S. Fauci, the nation’s leading infectious-disease specialist, and other health officials joined 25 faith leaders from across the D.C. region as they received their vaccines on camera.

“Religious figures are among the most trusted leaders, so seeing congregation leaders get vaccinated first can relieve anxiety and fears,” Melissa Rogers, the executive director of the White House Office of Faith-Based and Neighborhood Partnerships, said during the vaccination event in Washington.

Many states have prioritized all clergy members for the vaccine, while at least 17 have expanded eligibility to religious leaders who work only in hospitals or other health care settings. In some other states, all adults are already eligible.

Rabbi Mark Miller of Temple Beth El in Bloomfield Hills, Mich., who continued to preside over funerals during the pandemic, was vaccinated in January.

“With everything that went on in the country over the last year, one of the things that didn’t stop, and couldn’t stop, was funerals,” said Rabbi Miller, who has urged his congregants to get the vaccine when they become eligible.

In some places, religious leaders have pushed to become eligible because their work can place them at higher risk of contracting the virus. Bishop Daniel G. P. Gutiérrez of the Episcopal Diocese of Pennsylvania said he and other faith leaders started calling elected officials in December to ensure that clergy members would be vaccinated with other frontline workers. Though clergy members in most of Pennsylvania are still not eligible for the vaccine, the state has moved them into an earlier priority group than it had originally planned.

“People don’t recognize the 24-hour, seven-day-a-week ministry of a clergy,” Bishop Gutiérrez said. “Once we brought that to their attention, almost all said: ‘You’re right. Let’s do this.’”

Officials with the Utah Muslim Civic League, which has hosted vaccination events at mosques, said registration numbers had been growing. And in Washington, after the Rev. Patricia Hailes Fears of Fellowship Baptist Church became the first clergy member to receive the vaccine at the event with Dr. Fauci, some congregants took notice.

“I wasn’t even home from the cathedral, and I was getting phone calls from members of the congregation saying, ‘Pastor, we saw you! I’m getting my shot on Saturday,’” she said.

Across the country, public health officials have reached out to religious leaders in Black and Hispanic communities, which have sometimes reported significantly lower vaccination rates compared with their representation in the general population.

In Baltimore, the Rev. Terris King of Liberty Grace Church of God has set up virtual discussions for members of his predominantly Black congregation with representatives from health care companies, such as Pfizer. Governments need to work with churches, the reverend said, because religious leaders understand their communities’ needs and anxieties, with much of the mistrust stemming from historical and current mistreatment of people of color in the health care system.

“Many of them have seen what, as a researcher in minority health, I’ve always known, and that’s that the church is the trusted source in the African-American community around the country,” he said.

For some, New York City will never be the same.

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Ofelia Becerra Díaz, pictured with her daughter, Culy, lost a sister to Covid-19.Credit...Sasha Maslov for The New York Times

The old job, the old office, the old week — for many New Yorkers, the possibility of the return of something resembling their old life appears finally within reach. For them, the year of the pandemic was a blip, a pause, however frustrating, in their lives.

But for so many others, the old life is gone forever, washed away in tragedy, a job erased or a reordering of priorities.

New York may be just months away from seeming like its former self — restaurants and bars buzzing with people, subways full of vaccinated riders. The next few weeks will bring many reasons to feel hopeful. An increase in vaccine supply means appointments should be easier to secure, and the warmer weather will begin to draw people out of their homes.

But look closer and you see the truth. New York couldn’t possibly emerge from this year the same. Not after all this. Every street, block and building has suffered loss in some form.

The make-do adjustments, pivots and reactions of the last year have since calcified, becoming regular parts of the day. This is the new New York, and these are some of the new New York lives.

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Another word to add to the coronavirus lexicon: fauxmorbidity.

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People wait in line to receive the Covid-19 vaccine earlier this month at the Jacob K. Javits Convention Center in New YorkCredit...Peter Foley/EPA, via Shutterstock

After Covid-19 vaccines made by Pfizer and Moderna were approved for use in late 2020, anecdotes proliferated about rich people finding ways to jump the distribution priority line.

“I heard a lot from friends in Miami about people flying in, because they were giving it to everybody,” the writer Carole Radziwill said. “There was a lot of that in January.”

But a month later, as eligibility expanded in places like New York to include people with pre-existing conditions, such as cancer, severe obesity or cardiovascular disease, it began to appear as if a vaccine was available to anyone who was willing to hunt one down or stretch the truth about a mild circulatory or mental ailment — a “fauxmorbidity” — to justify an early shot.

To be fair, most comorbidities are invisible, and federal law protects the privacy of patients’ health information. And the more people who are vaccinated, the better. The supply of vaccines is supposed to increase dramatically over the next week or two, making these concerns less urgent.

Holly Peterson, who has written several novels about wealth in New York, heard about visibly slender people getting their vaccines early by citing, without much credibility, a high body mass index, or B.M.I.

To her, that seemed like “the equivalent of knocking over an old lady for a taxi and feeling good about yourself,” as she put it in an interview.

The generous phrase “including but not limited to” when one is asked to verify an “underlying condition as defined by the New York Department of Health” on the state’s comorbidities information sheet has been, for some, an open invitation to be creative with their medical history.

That people are publicly airing their vaccination status has made some who have been waiting for eligibility to broaden uneasy. “It’s broadcasting status, that you got the vaccine ahead of others,” said Erik Maza, the styles news director at Town & Country magazine. “We should all consider taking up the Garbo challenge and stay off social media for a spell instead of broadcasting every waking second of the day, including your vax shot.”

Teaching got harder during the pandemic. Now, fewer people want to enter the profession.

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Alanna Ehrike handing out milk and lunches to her fifth-grade class in Wausau, Wis., in December.Credit...Jenn Ackerman for The New York Times

Few professions have been more upended by the pandemic than teaching has, as school districts have vacillated between in-person, remote and hybrid models of learning, leaving teachers concerned for their health and scrambling to do their jobs effectively.

For students considering the profession, the disruptions in education this past year have seeded doubts, which can be seen in declining enrollment numbers.

A survey by the American Association of Colleges for Teacher Education found that teaching programs had a 19 percent drop in enrollment this year at the undergraduate level and an 11 percent decline at the graduate level. And Teach for America, which recruits recent college graduates to teach in low-income schools across the country, said it had received fewer applications for its fall 2021 corps compared with this period last year.

Many program leaders believed that enrollment numbers declined because of the perceived hazards posed by in-person teaching and the difficulties of remote learning, combined with longstanding frustrations over low pay compared with professions that require similar levels of education. (The national salary average for a public-school teacher was roughly $61,000 in 2017.) Some are hopeful that enrollment will return to its prepandemic level as vaccines continue to roll out and schools resume in-person learning.

But the challenges in teacher recruitment and retention run deeper: The number of education degrees conferred by American colleges and universities dropped 22 percent from 2006 to 2019, despite an overall increase in the number of graduates from universities in the United States, stoking concerns about a future teacher shortage.

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‘There’s just a sense of entitlement’: Hawaiians worry about a flood of heedless tourists.

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Passengers heading to Hawaii from Seattle-Tacoma International Airport this month.Credit...Ted S. Warren/Associated Press

Palakiko Chandler took their little cousins to Nanakuli Beach on Oahu last weekend and noticed something they hadn’t seen in a while: a parking lot full of rental cars. The tourists were back.

“It was just so packed,” said Mr. Chandler, 27 and a Native Hawaiian. “Me and my cousins were looking at each other like, should we just go home?” The youngest cousins needed several reminders to keep their distance from strangers for virus safety.

For much of the pandemic, Hawaii had some of the strictest rules for visitors in the United States, requiring a 14-day quarantine for everyone arriving in the islands. The policy took a heavy economic toll on a state that depends heavily on tourism, but it was lauded for its success in limiting the impact of the virus for months.

Now, though, Hawaii has reopened for travelers: A negative test within 72 hours of arrival lets them skip the quarantine in most places. At least 28,000 people arrived in Hawaii on each of the last two Saturdays, according to state travel data  the most in a day since the pandemic began, and not far from typical prepandemic levels.

The influx has residents worried. Some have been posting on social media for months, pleading with mainlanders not to come, or if they do, to be mindful of the islands’ isolation and limited resources. The state has a total of 3,000 hospital beds for its population of 1.4 million, and has among the fewest I.C.U. beds per capita of any state; they were often mostly full even before the pandemic.

Hawaii’s precautions did not keep the virus out completely: The islands had a holiday surge, like the rest of the country, and parts of the state are struggling with outbreaks now. Daily new case reports have doubled since late February, with some recent clusters focused on tourism workers. Hospitalizations have increased 17 percent in the last two weeks.

“The looming concerning things are the variants,” said Dr. Damien Kapono Chong-Hanssen of the Kauai Community Health Center. “The California variant has been implicated in what’s happening in Maui right now. Maui is not looking better.”

Mainlanders are making the trip anyway. “Hawaii is again packed with tourists,” wrote the travel site The Points Guy. Favorite sites are sold out, check-in lines are long, and the lines for outbound flights are getting longer.

Tourists are crowding popular beaches without wearing masks or paying much attention to social distancing. Some visitors have gotten rowdy. A pair of arriving tourists were sent home after trying to pay a bribe to avoid the testing requirement.

The situation is worsening the irritation that many state residents feel toward vacationers. Now the tourists aren’t just crowding the island and driving up prices, they say, they are also heedlessly risking everyone’s health.

“Hawaiians and locals alike have always seen the disrespect that tourists bring to our islands,” Mr. Chandler said. “This is kind of the last straw. You’re coming to our home and you’re endangering us during a pandemic.”

The tension is especially prevalent among Native Hawaiians and Pacific Islanders, who face greater risk for Covid-19 and higher rates of chronic disease than average.

“Local people are tired of being treated a certain type of way,” said Charles Kaua Taylor-Fulton, 20, who lives on Oahu. “When tourists come, they can be very rude or entitled. There’s just a sense of entitlement.”

Dr. Lee Buenconsejo-Lum of the University of Hawaii at Manoa said the state’s case numbers are not exploding, at least not yet. But she said she would like to see travelers exhibit the same commitment to wearing masks that locals have. “It’s a matter of constantly educating the tourists,” she said.

Still, the high travel season is just getting started, and restrictions are continuing to ease. Bars have reopened in parts of the state and outdoor weddings are now allowed to welcome up to 100 guests.

“We can already see into the future of summer,” Mr. Chandler said, “and it’s going to be packed.”

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