Coronavirus Updates The latest developments in the COVID-19 pandemic.
The novel coronavirus, first detected at the end of 2019, has caused a global pandemic.

Coronavirus Updates

Latest developments in the COVID-19 pandemic

Boxes containing the Johnson & Johnson COVID-19 vaccine, developed by the company's Janssen Pharmaceuticals unit, are shown at a vaccination center in Los Angeles last week. Allen J. Schaben/Los Angeles Times via Getty Images hide caption

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Allen J. Schaben/Los Angeles Times via Getty Images

Boxes containing the Johnson & Johnson COVID-19 vaccine, developed by the company's Janssen Pharmaceuticals unit, are shown at a vaccination center in Los Angeles last week.

Allen J. Schaben/Los Angeles Times via Getty Images

The European Union's drug regulator said Tuesday it had concluded there is a "possible link" between the Johnson & Johnson COVID-19 vaccine and several cases in the U.S. of a rare type of blood clot, but emphasized that the shot's benefits "in preventing COVID-19 outweigh the risks of side effects."

The assessment by the European Medicines Agency, or EMA, comes a week after the U.S. Centers for Disease Control and Prevention and the Food and Drug Administration announced a "pause" in the distribution of the Johnson & Johnson vaccine, developed by the company's Janssen Pharmaceuticals unit, after reporting six cases of cerebral venous sinus thrombosis — a rare type of blood clot — seen in combination with low levels of blood platelets.

The EMA said it had reviewed eight cases of unusual blood clots in the U.S., one of which was fatal, occurring within three weeks of receiving the single-dose Johnson & Johnson vaccine. The agency determined a warning should be added to the vaccine's product information.

"I have to stress again [the cases] are very rare and in the vast majority of cases these vaccines are going to prevent death and hospitalization from COVID-19," EMA Executive Director Emer Cooke said in a briefing. "We have to balance the benefits of the vaccine with the risks."

In a statement, the EMA said that although the chance of experiencing the side effect is "very low," people "should still be aware of symptoms so they can get prompt medical treatment to help recovery and avoid complications."

The pause in distribution in the U.S. due to a handful of cases has also complicated the rollout of the vaccine in Europe, which has been trying to ramp up its immunization campaign. The EU's efforts have also been stymied by reports last month of similarly rare cases of unusual blood clots linked to the vaccine made by AstraZeneca, Europe's primary supplier.

The EMA investigated the AstraZeneca cases and concluded that the vaccine is safe and effective and that its benefits far outweigh the potential risks.

The EU regulator said the eight U.S. cases it examined occurred in people under 60, mostly women. The small number of cases was among more than 7 million doses administered in the U.S. through April 13.

Peter Arlett, the head of data analytics at the EMA, said that the EU agency had also reviewed 287 occurrences with the AstraZeneca vaccine, 25 with the Pfizer-BioNTech vaccine and five with Moderna's vaccine.

The U.S. Department of State will add a slew of countries to its "Do Not Travel List" later this week because of coronavirus danger. Paul J. Richards/AFP via Getty Images hide caption

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Paul J. Richards/AFP via Getty Images

The U.S. Department of State will add a slew of countries to its "Do Not Travel List" later this week because of coronavirus danger.

Paul J. Richards/AFP via Getty Images

The U.S. State Department on Monday announced plans to expand travel advisories, urging U.S. citizens to stay home as the COVID-19 pandemic continues to pose "unprecedented risks" around the globe.

The updated travel guidelines are intended to curb visits "to approximately 80% of countries worldwide" that are experiencing dramatic spikes in cases, the department said in a statement. New guidance is expected be released later this week.

The latest recommendations come as the coronavirus "continues to pose unprecedented risks to travelers," and the new guidelines "better reflect the Centers for Disease Control and Prevention's science-based Travel Health Notices," according to the notice.

The State Department added: "As always, we are closely monitoring conditions around the globe, and will regularly update our destination-specific advice to U.S. travelers as conditions evolve."

As of Monday afternoon, the Johns Hopkins Coronavirus Resource Center reported 141,786,586 COVID-19 cases around the world. The United States has confirmed more cases than any other country in the world — 31,733,400 with India, Brazil, France, Russia, the United Kingdom, Turkey, Italy, Spain and Germany rounding out the top 10 spots. Meanwhile, global deaths have surpassed 3 million, according to the latest data.

French President Emmanuel Macron in March extended a nationwide lockdown through the end of April, citing new, faster-spreading variants of the coronavirus. He called it "an epidemic within the epidemic."

As NPR reported, "In Brazil, deaths have topped 3,000 per day as the country is ravaged by the virus. Mexico has recorded more than 211,000 deaths. India has had more than 175,000 deaths and deaths in the United Kingdom have topped 127,000."

Joy, Relief In Airports As Australia And New Zealand Open 'Travel Bubble'

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Families are reunited as travelers arrive on the first flight from Sydney in Wellington on Monday after Australia and New Zealand opened a trans-Tasman quarantine-free travel bubble. Marty Melville/AFP via Getty Images hide caption

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Families are reunited as travelers arrive on the first flight from Sydney in Wellington on Monday after Australia and New Zealand opened a trans-Tasman quarantine-free travel bubble.

Marty Melville/AFP via Getty Images

On Monday, Australia and New Zealand launched their long-anticipated travel bubble that will allow residents of each country to visit the other without having to quarantine upon arrival.

Emotional videos capturing long-awaited reunions in arrival halls in various airports across Australia and New Zealand have been circulating online since the first passengers touched down. Thousands are reported to have made the journey across the Tasman Sea in the bubble's opening first day.

Traveler Mark Carrington told Australia's Seven Network that he felt "amazing" after landing in Sydney.

"It's been nearly two years and I haven't seen my partner for that period of time. So it's been very tough," he said.

Before her flight to New Zealand, traveler Denise O'Donoughue told AFP that she felt like the world was returning to some sort of normal.

"What normal's going to be from now on I don't know, but I'm just really, really excited about today," she said.

Until now, New Zealand had required travelers from Australia to quarantine upon arrival. Most Australian states had dropped that requirement late last year.

New Zealand Prime Minister Jacinda Ardern told reporters Monday that the Australia-New Zealand bubble is a significant step in getting New Zealand back to normal.

"What the bubble will mean for each of us personally is important, but what's also important is what it will mean for the economy and our recovery," she said. "According to Tourism New Zealand Forecasting, welcoming Australians back could mean a billion-dollar boost."

Australian Prime Minister Scott Morrison also told reporters that the bubble is a win-win for both countries, who depend greatly on each other for tourism. New Zealand government data shows that about 1.5 million Australians visited New Zealand in 2019, making up about 40% of all visitors and spending nearly the equivalent of $2 billion USD. And about 1.3 million New Zealanders visited Australia that year, accounting for about 15% of all visitors to Australia.

This arrangement has been months in the making after both New Zealand and Australia shut down their borders to most travelers at the start of the pandemic last spring. Compared with many other countries, the two have avoided the worst of the virus.

Australia has logged 29,543 cases and 910 deaths, while New Zealand only 2,596 cases and 26 deaths from the coronavirus, according to Johns Hopkins University.

However, the vaccine rollout in both countries has been slow to get started.

The new travel bubble is not without rules. For example, residents cannot have traveled outside of their country within 14 days and must be without COVID symptoms before departure. They also must continue to wear masks on flights.

Jennifer Nuzzo at the Johns Hopkins Center for Health Security says that while the travel bubble is a step toward normalcy, it's not without risks.

"It's not zero-risk to allow travel in and out of countries. And we've seen this most acutely in Australia where there have been a number of clusters found probably related to travel," she tells NPR. "So it is possible that both countries could see clusters here and there. But so far they've demonstrated a commitment to respond when they do occur."

Nuzzo says it would be difficult to create similar travel bubbles in countries such as the U.S., given that both Australia and New Zealand are much more geographically isolated.

Throughout the pandemic, various plans for travel bubbles have been discussed between countries and cities, including one among the Baltic states that was started, stopped and started again over the last year. Elsewhere in the Pacific, Taiwan and Palau launched their own no-quarantine travel bubble earlier this month.

April 17

Global COVID-19 Deaths Top 3 Million

Relatives attend a COVID-19 victim's burial at a cemetery in Manaus, Amazonas state, Brazil, on Thursday. Michael Dantas/Getty Images hide caption

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Global deaths from COVID-19 has surpassed 3 million, according to the latest data from John Hopkins University.

Leading in those deaths are the United States, with more than 566,000, and Brazil, with more than 368,000. They are followed by Mexico, India and the United Kingdom.

The global death toll reached 1 million in September 2020 and 2 million in January.

The grim milestone comes after health officials in the U.S. paused rollout of the single-dose Johnson & Johnson vaccine after six women experienced rare but severe blood clots a week or two after receiving it.

Overall, more than 129 million people in the U.S. have received at least one dose of COVID-19 vaccine, including 7.8 million doses of the J&J vaccine. More than 82 million Americans — nearly 25% of the population — have been fully vaccinated.

In Brazil, deaths have topped 3,000 per day as the country is ravaged by the virus. Mexico has recorded more than 211,000 deaths. India has had more than 175,000 deaths and deaths in the United Kingdom have topped 127,000.

COVID-19 variants are spreading throughout the U.S., with the more contagious U.K. variant, B.1.1.7, now dominant. On Friday, the Biden administration announced plans to spend $1.7 billion on combating and tracking variants.

Ex-FDA Chief Sees 'Struggle' To Vaccinate More Than Half U.S. Population

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Dr. Scott Gottlieb, then commissioner of the Food and Drug Administration, testifies during a House hearing on in October 2017. In an NPR interview, Gottlieb says he doesn't expect enough demand for the COVID-19 vaccine much beyond 160 million Americans. Drew Angerer/Getty Images hide caption

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Dr. Scott Gottlieb, then commissioner of the Food and Drug Administration, testifies during a House hearing on in October 2017. In an NPR interview, Gottlieb says he doesn't expect enough demand for the COVID-19 vaccine much beyond 160 million Americans.

Drew Angerer/Getty Images

One in 4 Americans would refuse a coronavirus vaccine if offered, a recent NPR/Marist poll found. Another 5% are "undecided" about whether they would get the shot. And some researchers are growing worried that this reluctance will be enough to prevent the nation from reaching what's known as herd immunity.

A former head of the Food and Drug Administration also has doubts about reaching herd immunity, the point at which the virus can no longer spread easily through the population.

More than 123 million people, or about 37% of the U.S. population, have received at least one dose of a COVID-19 vaccine and Dr. Scott Gottlieb, who was FDA commissioner from 2017 to 2019, says the nation is reaching a point where supply will outstrip demand. Gottlieb is on the board of directors of Pfizer, which makes one of the coronavirus vaccines.

"I think that there's probably 150 million Americans who are eager to get vaccinated. And as we expand into the younger age cohorts and a new eligible population ... you're not going to see the demand be as brisk," Gottlieb says in an interview with NPR's Morning Edition.

"I think we get to 150 million vaccines. I think we struggle to get to 160 million," he says, which is roughly half the U.S. population. "Beyond that, I think it's going to be difficult. I'm not sure that you have the demand there."

But it's not as bad as that sounds.

"I don't know that we ever get to herd immunity," Gottlieb says. "But I think the combination of vaccinating that many people and having a lot of immunity in the population from prior infections, [is] enough that the level of spread of this virus is going to be substantially reduced."

On Tuesday, the FDA and Centers for Disease Control and Prevention recommended a pause in the use of the Johnson & Johnson COVID-19 vaccine, pending a review of reports of very rare, potentially dangerous blood clots.

Blood clots were found in six recipients, one of whom died. Those affected, all of whom were women, were among about 7 million people in the U.S. who received the J&J shots.

Gottlieb said he expects the pause to be short.

"I think this is probably a temporary pause where the agency is going to evaluate the information it has, see if there is more cases out there to be reported into the agency, perhaps issue some guidance around the use of the vaccine and what doctors should be alert for and then allow the vaccine to continue to be distributed," he says.

He adds, "I think it's more likely than not that there's going to be a resumption in the use of the vaccine for some portion of the population. That should be reassuring to the public."

Jeevika Verma and Arezou Rezvani produced and edited this interview for broadcast.

Jeevika Verma, Milton Guevara, Ziad Buchh, Arezou Rezvani and Fernando Pizarro produced and edited the audio version of this story. Avie Schneider produced for the Web.

Danish health authorities announced Wednesday that the country will continue its COVID-19 vaccine rollout without the shot made by AstraZeneca, citing its possible link to rare blood clotting events, the availability of other vaccines and the "fact that the COVID-19 epidemic in Denmark is currently under control." Dirk Waem/BELGA MAG/AFP via Getty Images hide caption

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Dirk Waem/BELGA MAG/AFP via Getty Images

Danish health authorities announced Wednesday that the country will continue its COVID-19 vaccine rollout without the shot made by AstraZeneca, citing its possible link to rare blood clotting events, the availability of other vaccines and the "fact that the COVID-19 epidemic in Denmark is currently under control."

Dirk Waem/BELGA MAG/AFP via Getty Images

Denmark will stop administering the AstraZeneca COVID-19 vaccine, health officials said Wednesday.

In a statement, the Danish Health Authority emphasized that the shot's benefits outweigh the risks for those who do get it, but said they had decided to discontinue its use because of its possible link to rare cases of blood clotting and the "fact that the COVID-19 epidemic in Denmark is currently under control and other vaccines are available."

"Based on the scientific findings, our overall assessment is there is a real risk of severe side effects associated with using the COVID-19 vaccine from AstraZeneca," said Søren Brostrøm, director general of the Danish Health Authority. "We have, therefore, decided to remove the vaccine from our vaccination [program]."

All AstraZeneca vaccination appointments will be cancelled, and those who have already received their first dose will get their second in the form of another vaccine, officials said. Individuals who have had forthcoming appointments cancelled will be able to reschedule "based on an assessment of the current epidemic situation."

"The consequence of this decision is that anyone aged 16 or older can expect to receive an offer of vaccination in late June," officials said. "Thus, everyone who accepts the offer will be fully vaccinated about five weeks later – in early August."

COVID-19 cases and deaths have decreased considerably in Denmark following a winter surge. The country reported 4,552 new cases and 14 deaths in the past week, according to data from Johns Hopkins University.

Just under 8% of the population has been fully vaccinated, according to Johns Hopkins. Of that group, Reuters reports that 77% got the Pfizer vaccine, 7.8% had Moderna and 15.3% received AstraZeneca.

Denmark was one of several European countries to temporarily suspend use of the AstraZeneca vaccine in mid-March in order to investigate reports of rare blood clotting events in some recipients.

The European Medicines Agency and World Health Organization both continued to recommend its use, and many of those countries resumed vaccinations within a few days following a preliminary EMA investigation that concluded its benefits outweighed its risks.

Wednesday's announcement comes exactly one week after the EMA said rare blood clotting events should be listed as a possible side effect of the AstraZeneca vaccine, but stressed that it has been proven to prevent severe disease, hospitalization and death from COVID-19. Such clotting events are rare, officials emphasized, and appear to be more common in women under the age of 60.

Several countries including France, Germany and South Korea have reintroduced the vaccine with age restrictions, while others including Australia, Greece and Britain are now recommending alternatives for young people.

Also on Wednesday, the EMA announced that it is continuing to monitor the phenomenon of "very rare blood clots with low blood platelets" occurring after vaccination, and will review more data at the request of the EU's Commissioner for Health and Food Safety.

The review will provide more context on the benefits of ongoing vaccination campaigns, it said, and consider whether to update recommendations for a second dose for those who have already received their first dose of AstraZeneca's vaccine. Public health experts have been largely hesitant about the idea of mixing and matching vaccines without more data, and a newly-expanded U.K. study is working to assess the potential benefits.

"EMA considers the overall benefits of the vaccine continue to outweigh the risks in people being vaccinated," it said, adding that the review "will support ongoing national vaccination campaigns in their decisions on how to optimally deploy the vaccine."

The EMA said last week that the use of the vaccine in member nations' vaccination campaigns would vary based on the severity of the pandemic and availability of vaccines in each country, Danish authorities noted.

And in the case of Denmark, they said, the country has already made progress vaccinating the older age groups at highest risk of becoming severely ill, and has vaccines made by Pfizer-BioNTech and Moderna at its disposal.

Danish authorities said research and scientific studies in Denmark revealed a "higher than expected frequency" in the number of blood clotting events, particularly in veins in the brain, following vaccination.

Brostrøm described the situation as "a known risk of severe adverse effects from vaccination with AstraZeneca, even if the risk in absolute terms is slight."

Brostrøm emphasized that the AstraZeneca vaccine is still approved. He also said that the country may reintroduce it at a later point if the situation changes.

"If Denmark were in a completely different situation and in the midst of a violent third outbreak, for example, and a healthcare system under pressure – and if we had not reached such an advanced point in our rollout of the vaccines – then I would not hesitate to use the vaccine, even if there were rare but severe complications associated with using it," Brostrøm said.

The AstraZeneca vaccine is not currently being used in the U.S., though the company has said it will seek emergency use authorization from the Food and Drug Administration.

Meanwhile, the U.S. is reviewing its own reports of rare blood clotting cases — six out of nearly 7 million doses — in the single-shot Johnson & Johnson vaccine. The FDA on Tuesday recommended its use be paused "out of an abundance of caution" while it reviews data.

That same day, the company announced it would "proactively delay" the rollout of its vaccine in Europe. On the subject of Johnson & Johnson, Danish health officials said they are closely monitoring the risk assessments initiated by authorities in the U.S. and Europe, and will cooperate with research into the safety and efficacy of that and all COVID-19 vaccines.

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention have recommended a pause in the use of the Johnson & Johnson COVID-19 vaccine, shown here in a hospital in Denver. David Zalubowski/AP hide caption

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David Zalubowski/AP

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention have recommended a pause in the use of the Johnson & Johnson COVID-19 vaccine, shown here in a hospital in Denver.

David Zalubowski/AP

The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration said Tuesday they are recommending a "pause" in the use of the single-dose Johnson & Johnson COVID-19 vaccine out of an "abundance of caution" while a review of reports of rare, potentially dangerous blood clots is conducted.

In a joint statement on Tuesday, the two agencies said they are "reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine."

"In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia)," said Dr. Anne Schuchat, principal deputy director of the CDC, and Dr. Peter Marks, director of the Food and Drug Administration's Center for Biologics Evaluation and Research. "All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination."

"Right now, these adverse events appear to be extremely rare," the statement added.

Speaking at a virtual news briefing after the announcement, Marks said that symptoms averaged about a week to nine days after vaccination, but not longer than three weeks.

He said it is important to make physicians aware that CVST together with low blood platelets in a patient — as the cases to date have shown — should not receive the standard treatment for blood clots, which in these cases "can actually cause tremendous harm." A blood thinner called heparin is commonly used to treat clots like these under normal circumstances.

Schuchat described CVST as a "stroke-like" illness. She said the symptoms are different from the mild flu-like ones that many people experience after getting a coronavirus vaccine dose.

"I know that the information we are providing today will be very concerning to Americans" who already received this particular vaccine, she acknowledged.

Schuchat said the CDC's Advisory Committee on Immunization Practices (ACIP) would meet on Wednesday. Acting FDA Commissioner Janet Woodcock, who moderated the virtual briefing, said the review would likely take "a matter of days."

At a White House briefing later, Dr. Anthony Fauci, the Biden administration's chief medical adviser on COVID-19, said he understood the review to be "more like days to weeks than weeks to months."

Schuchat and Marks recommended that individuals who had already received the Johnson & Johnson vaccine who experience severe headache, abdominal pain, leg pain, or shortness of breath within three weeks of getting the shot contact their health care provider.

Following the recommended pause in vaccination with the Johnson & Johnson vaccine, Jeffrey Zients, the White House coronavirus coordinator, said, "we are working now with our state and federal partners to get anyone scheduled for a J&J vaccine quickly rescheduled for a Pfizer or Moderna vaccine."

Zients, who also joined Fauci at the afternoon White House briefing, said there are more than enough Pfizer and Moderna doses available to make up for any temporary shortfall in the Johnson & Johnson shots.

"In certain locations, people who were scheduled for today are already rescheduled," he said.

Fauci emphasized that after tens of millions of doses of the Pfizer and Moderna vaccines had been administered, there are "no red flags." He said that fact was a solid indication that the vaccines are "very safe."

Fauci, asked if he thought the decision to pause use of the Johnson & Johnson vaccine was premature given the small number of cases of CVST, said: "We want to get this worked out as quickly as we possibly can."

"That's why we use the word 'pause,'" he said, adding, "I don't think it means that we pulled the trigger too soon."

Marks said the joint CDC/FDA recommendation was "not a mandate." He said that case by case, a doctor and patient could make a determination whether the Johnson & Johnson vaccine was appropriate. "We are not going to stop a provider from administering the vaccine," he added.

The New York state health commissioner, Dr. Howard Zucker, said the state would suspend its use of the vaccine pending results of the federal investigation.

In a statement sent to NPR, Johnson & Johnson said it was "aware of an extremely rare disorder involving people with blood clots in combination with low platelets in a small number of individuals who have received our COVID-19 vaccine."

"We have been working closely with medical experts and health authorities, and we strongly support the open communication of this information to healthcare professionals and the public," the company said.

Johnson & Johnson said it was also reviewing the cases with European health authorities and that in the meantime, it will "proactively delay the rollout of our vaccine in Europe."

More than 6.8 million doses of the Johnson & Johnson vaccine have already been administered in the U.S., alongside tens of millions of doses of vaccines produced by Pfizer-BioNTech and Moderna. The Johnson & Johnson vaccine received FDA emergency authorization for distribution in February.

Similar concerns over rare blood clots have been raised over the Oxford-AstraZeneca vaccine, which has been widely administered in the United Kingdom, European Union and many other countries. Last week, the European Union's drug regulator said the benefits of the vaccine outweigh its risks.

Marks called the situation with the J&J vaccine that is currently under review "very similar" to the one experienced with AstraZeneca's vaccine.

He said that among the people who've received 180 million doses of vaccine by Pfizer and Moderna, no cases of CVST with low blood platelets have been seen.

The recommended pause in U.S. inoculations using the Johnson & Johnson vaccine could further complicate the immunization drive against COVID-19, which has killed more than 562,000 people in the U.S., amid an uptick in new coronavirus infections and "vaccine hesitancy" among certain groups.

Amid manufacturing issues at a facility in Baltimore, Johnson & Johnson has had difficulty ramping up production. It has promised to deliver 100 million doses of its vaccine to the U.S. government by the end of May.

Millions Flock To Hindu Festival Amid Coronavirus Spike

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Men take a holy dip in the Ganges River on the occasion of first royal bath of Shivratri festival during Maha Kumbh Festival in Haridwar, India. Ritesh Shukla/NurPhoto via Getty Images hide caption

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Men take a holy dip in the Ganges River on the occasion of first royal bath of Shivratri festival during Maha Kumbh Festival in Haridwar, India.

Ritesh Shukla/NurPhoto via Getty Images

HYDERABAD, India — One of the largest gatherings of people in the world continues in northern India amid a sharp rise in coronavirus cases and a weakening supply of vaccines.

Almost 3 million Hindu pilgrims have bathed in the Ganges River as part of this year's Kumbh Mela festival, raising concerns that the festival could become a super spreader event. On Monday, the festival's second-holiest day, India's Health Ministry reported nearly 170,000 new coronavirus infections. India's total caseload has become the second-highest in the world after the United States.

On the banks of the Ganges, Hindu prayer music is interrupted by whistles from police, trying unsuccessfully to enforce social distancing rules.

Police are using artificial intelligence-enabled surveillance cameras to spot people not wearing masks. But because of the huge crowds, it's practically impossible to issue fines on those not abiding by the rules, Sanjay Gunjyal, who's in charge of security for the festival, told local media.

India's drug regulator authorized the Russian vaccine Sputnik V "for restricted use in emergency situations" Tuesday, making it the third available vaccine in India. The country has so far administered more than 100 million doses of vaccines but at this rate, experts say it would take years to immunize the entire population of nearly 1.4 billion.

Even as the virus surges to its worst level, daily life remains unaffected in most parts of the country. Prime Minister Narendra Modi and other politicians have addressed massive campaign rallies in several states holding local elections.

When Muslim scholars held a congregation in New Delhi last year, before India's lockdown, politicians and many from India's Hindu majority blamed Muslims for spreading the coronavirus.

Last month, when reporters asked Uttarakhand's chief minister about COVID-19 concerns ahead of the Hindu Kumbh Mela festival, he said no one would be stopped from coming because of the pandemic.

"Pilgrims' faith will overcome the fear of the virus," he said.

Hospital workers tend to a Covid-19 patient at Queen Alexandra Hospital in Portsmouth, England, last month. Researchers have found that the so-called U.K. variant of the coronavirus isn't more likely to lead to death or severe illness. Adrian Dennis/AFP via Getty Images hide caption

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Hospital workers tend to a Covid-19 patient at Queen Alexandra Hospital in Portsmouth, England, last month. Researchers have found that the so-called U.K. variant of the coronavirus isn't more likely to lead to death or severe illness.

Adrian Dennis/AFP via Getty Images

People infected with the U.K. variant of the coronavirus didn't experience more severe symptoms and weren't more likely to die from this particular strain, according to a new study of hospitalized patients published Monday.

The strain, called the B.1.1.7 variant, remains more contagious than original strains of the virus however, according to the study in The Lancet Infectious Diseases.

The U.K. strain is believed to have first emerged in England in September 2020, according to the Centers for Disease Control and Prevention. It is now the most common strain in the U.S.

Researchers for The Lancet study collected samples from patients at the University College London Hospital and the North Middlesex University Hospital between Nov. 9 to Dec 20, 2020. The samples were collected just prior to a surge in hospitalizations in England and Ireland due to the rapid spread of this particular strain of the coronavirus.

Scientists sequenced samples from 341 patients and found 58 percent were positive for the B.1.1.7 variant. The other 42 percent were infected with a different strain, according to the study. Researchers compared the severity of symptoms between the two groups and found those with the B.1.1.7 strain were not particularly worse off than those with other virus variants.

Patients who tested positive for the the B.1.1.7 variant also reportedly had higher "viral loads," or greater amounts of the virus in their bodies.

A health worker vaccinates a Buddhist monk sitting in front of a portrait of Bhutanese King Jigme Khesar Namgyel Wangchuck at a secondary school in Bhutan on March 27, the first day of the country's vaccination campaign. Less than two weeks later, health officials said 93% of eligible adults had received their first dose of a COVID-19 vaccine. Upasana Dahal/AFP via Getty Images hide caption

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A health worker vaccinates a Buddhist monk sitting in front of a portrait of Bhutanese King Jigme Khesar Namgyel Wangchuck at a secondary school in Bhutan on March 27, the first day of the country's vaccination campaign. Less than two weeks later, health officials said 93% of eligible adults had received their first dose of a COVID-19 vaccine.

Upasana Dahal/AFP via Getty Images

It took less than two weeks for the Himalayan kingdom of Bhutan to vaccinate almost all of its eligible population.

The country's vaccination campaign kicked off on March 27. By April 8, according to the Ministry of Health, 93% of eligible adults had gotten their first dose. Officials said 472,139 people between ages 18 and 104 had been vaccinated as of that date, and they urged other eligible individuals to follow suit.

In a statement, Health Minister Dasho Dechen Wangmo described the campaign as a "sense of purpose that each of us is embracing to protect our country and the people we love." She urged individuals to get vaccinated to protect themselves and their communities — as well as King Jigme Khesar Namgyel Wangchuck.

"His Majesty the King has shared thoughts about taking the vaccine only after every eligible person in the country received their shots safely," she said. "All of us must come forward, so that we make way for His Majesty to receive the vaccine as soon as possible."

Overall, roughly 64% of Bhutan's 735,553 residents have been vaccinated so far. That puts the nation's rollout just behind that of Seychelles, which has vaccinated 66% of its population of nearly 100,000, according to The Associated Press.

Health officials said second doses will be administered after eight to 12 weeks. The country received 550,000 doses of the AstraZeneca vaccine, known locally as Covishield, in two batches in January and March from India, Daily Bhutan reported.

Bhutan launched its vaccination campaign at the end of last month to coincide with "auspicious dates in Buddhist astrology," the AP said. On March 27, a 30-year-old bureaucrat became the country's first COVID-19 vaccine recipient, followed by Prime Minister Lotay Tshering, his family members and various cabinet ministers.

"Given the infection rate of the disease, we need above 70 percent coverage in order to attain the desired herd immunity," Tshering said in a statement. "With the overwhelming support of all Bhutanese, we will be one of the first countries to achieve that."

The vaccines were distributed to more than 1,200 sites across the country using cold-chain storage that the AP says was used during earlier vaccination drives. Nearly 3,300 health workers and 4,400 citizen volunteers known as desuups were deployed across the country to help with the rollout, the Health Ministry said.

More than 85% of the country's eligible adults had received their first dose within seven days, officials said. While the formal vaccination campaign was set to last only one week, shots were still available at certain health centers for people who had not received them, and individuals with mobility issues can sign up for home-based vaccinations until Tuesday.

State-owned newspaper Kuensel stated in an editorial that the country's efforts to fight the coronavirus pandemic have been "exemplary right from the beginning," thanks to leadership, front-line workers and what the paper describes as a cooperative public.

While noting it's premature to celebrate before people have had their second doses, it said that the country's size had certainly contributed to the vaccine's successful rollout — and that this has implications for tackling other issues related to the economy, unemployment and technology.

"As we realise the advantage of our smallness from the vaccination programme, it is a lesson too valuable to not replicate in our other endeavours," it concluded.

As of Monday, the country had recorded 921 cases and one death from COVID-19 since the start of the pandemic. Health officials said there will be no changes to public health restrictions until at least two weeks after the country completes a rollout of second-dose vaccinations, in two to three months.

Two Centers for Disease Control and Prevention studies released Monday shed new light on the racial and ethnic disparities in hospitalizations and emergency visits related to COVID-19 last year. Blake Nissen/Boston Globe via Getty Images hide caption

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Blake Nissen/Boston Globe via Getty Images

Two Centers for Disease Control and Prevention studies released Monday shed new light on the racial and ethnic disparities in hospitalizations and emergency visits related to COVID-19 last year.

Blake Nissen/Boston Globe via Getty Images

Days after declaring racism a serious public health threat, the Centers for Disease Control and Prevention released a pair of studies further quantifying the disproportionate impact of COVID-19 on communities of color.

The studies, published Monday in Morbidity and Mortality Weekly Report, examine trends in racial and ethnic disparities in hospitalizations and emergency room visits associated with COVID-19 in 2020.

CDC Director Rochelle Walensky said at a regular White House COVID-19 Response Team briefing that the new literature underscores the need to prioritize health equity, including in the country's accelerating vaccine rollout.

"These disparities were not caused by the pandemic, but they were certainly exacerbated by [it]," Walensky said. "The COVID-19 pandemic and its disproportional impact on communities of color is just the most recent and glaring example of health inequities that threaten the health of our nation."

After assessing administrative discharge data from March to December 2020, the CDC found that the proportion of hospitalized patients with COVID-19 was highest for Hispanic and Latino patients in all four census regions of the U.S.

Racial and ethnic disparities were most pronounced between May and July, it said, and declined over the course of the pandemic as hospitalizations increased among non-Hispanic white people. But such disparities persisted across the country as of December, most notably among Hispanic patients in the West.

The findings build on earlier studies about racial and ethnic disparities in COVID-19 hospitalizations by showing how they shifted over time and between regions.

Researchers point to two driving factors for the disproportionate hospitalizations among these minority groups: a higher risk of exposure to the virus and a higher risk for severe disease. They said differences in exposure risk associated with occupational and housing conditions, as well as socioeconomic status, are likely behind the demographic patterns they observed.

"Identification of the specific social determinants of health (e.g., access to health care, occupation and job conditions, housing instability, and transportation challenges) that contribute to geographic and temporal differences in racial and ethnic disparities in COVID-19 infection and poor health outcomes is critical," they said, adding that a better understanding of these factors at the local level can help tailor strategies to prevent illness and allocate resources.

The second study examined COVID-19-related emergency department visits in 13 states between October and December, and found similar disparities between racial and ethnic groups.

During that period, Hispanic and American Indian or Alaska Native people were 1.7 times more likely to seek care than white people, and Black individuals 1.4 times more likely.

Researchers noted that these racial and ethnic groups are also impacted by long-standing and systemic inequities that affect their health, such as limited access to quality health care and disproportionate representation in "essential" jobs with less flexibility to take leave or work remotely.

"Racism and discrimination shape these factors that influence health risks; racism, rather than a person's race or ethnicity, is a key driver of these health inequities," they explained.

Such inequities can increase the risk of exposure and delayed medical attention, further heightening the risks for severe disease outcomes and the need to seek emergency care.

Looking ahead, researchers said their findings could be used to prioritize vaccines and other resources for disproportionately affected communities in an effort to reduce the need for emergency care. Walensky also emphasized the implications of the new studies on and beyond the country's pandemic response.

"This information and the ongoing surveillance data we see daily from states across the country underscore the critical need and an important opportunity to address health equity as a core element in all of our public health efforts," she said.

A renewed push to address such inequity is now underway at the CDC, which late last week declared racism a "serious public health threat that directly affects the well-being of millions of Americans."

Walensky has directed the agency's departments to develop interventions and measure health outcomes in the next year. It's also provided $3 billion to support efforts to expand equity and access to vaccines, in addition to $2.25 billion previously allocated for COVID-19 testing in high-risk and underserved communities. The CDC has also launched a Racism and Health web portal to promote education and dialogue on the subject.

One area of particular focus is making sure the distribution of COVID-19 vaccines across the U.S. reaches the communities that have been hit hardest.

Data so far indicate that Black individuals make up roughly 12% of the country's population but just 8.4% of those who have received at least one dose, Walensky said. And while 18% of the country identifies as Hispanic or Latino, she said, they make up only 10.7% of those who have been vaccinated.

Officials at Monday's briefing highlighted further progress in the race to get shots into arms, noting that 120 million Americans have been vaccinated — 46% of adults have had at least one dose and 28% are fully vaccinated. And in exactly one week, all adults will be eligible to sign up for an appointment.

"This means that there has never been a better time than now for seniors and those eligible to get their shots," said Andy Slavitt, senior advisor on the White House COVID-19 Response Team. "Make an appointment today. And if you have someone in your life, particularly a senior, who has not gotten a shot yet, reach out and see what help they need."

People wait in front of the vaccination center in Gelsenkirchen, Germany, Wednesday, last week. Germany's health minister says the country is exploring purchasing the Sputnik V COVID-19 vaccine from Russia. Martin Meissner/AP hide caption

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Martin Meissner/AP

People wait in front of the vaccination center in Gelsenkirchen, Germany, Wednesday, last week. Germany's health minister says the country is exploring purchasing the Sputnik V COVID-19 vaccine from Russia.

Martin Meissner/AP

BERLIN — The German government is preparing to enter into negotiations with Moscow to pre-order doses of Russia's coronavirus vaccine, Sputnik V, breaking from the EU's joint vaccine procurement efforts.

Following a meeting with his EU counterparts on Wednesday, Federal Health Minister Jens Spahn said that because the EU Commission does not intend to purchase the Russian vaccine for the entire bloc, Germany will go it alone.

Thierry Breton, the EU commissioner in charge of vaccine procurement argues that Sputnik doses would not arrive in time to make any difference to the European Union's vaccination efforts.

But the German health minister sees Sputnik as a stop-gap solution to the current vaccine dose shortage caused by myriad supply issues. Speaking to public broadcaster WDR on Thursday, Spahn cautioned that any potential order of Sputnik V would need to be delivered within two to five months in order to make a difference to Germany's faltering vaccine rollout.

While EU member state Hungary has already started using the Russian vaccine, a German deal with Moscow is contingent upon Sputnik V being approved by the European Medicines Agency, the EU's drug regulator. The EMA started its review of the vaccine in March.

There's already support for the health minister's procurement plans at state level, particularly in formerly Communist region of eastern Germany, such as Saxony-Anhalt and Thüringen. Those states' premiers have long been calling for negotiations with Moscow.

Reiner Haseloff, state premier of Saxony-Anhalt, says that while the EMA must authorize the vaccine, he has faith in its efficacy, adding that he gratefully received the Soviet polio vaccine as a child in the former East Germany, where inoculation against the disease was rolled out earlier than in West Germany.

Meanwhile, initial hesitancy in western Germany about the speed with which the Russians approved Sputnik is waning. The state of Bavaria is even one step ahead of the federal government and has signed a letter of intent to buy up to 2.5 million doses of the Sputnik V vaccine, provided it receives EMA approval. The Bavarians hope to start manufacturing Sputnik at home, in the town of Illertissen.

But the unilateral move by prosperous Bavaria has not gone down well with other, less-wealthy German states, which fear being left behind. Their calls for solidarity in procuring and distributing vaccines echo those made by EU member states at the beginning of the year when they agreed not to enter into exclusive talks with suppliers.

European Court of Human Rights President Robert Spano delivered the court's ruling on vaccine mandates, saying the benefits of such laws outweigh the intrusion into privacy. European Court of Human Rights/Screenshot by NPR hide caption

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European Court of Human Rights/Screenshot by NPR

European Court of Human Rights President Robert Spano delivered the court's ruling on vaccine mandates, saying the benefits of such laws outweigh the intrusion into privacy.

European Court of Human Rights/Screenshot by NPR

European countries can legally require childhood vaccinations, the European Court of Human Rights ruled on Thursday. The decision covers preschool vaccinations for children, but it could also have an impact on the EU's battle to control the COVID-19 pandemic.

Compulsory vaccines can be seen as "necessary in a democratic society," the Strasbourg-based court said in its ruling, which came on a 16-1 vote.

A Czech man had challenged his country's vaccine requirement for young children, after being fined for refusing to have his son and daughter vaccinated against tetanus, hepatitis B and polio. The plaintiff, Pavel Vavricka, said the law infringed on his family's right to a private life. Five other families filed similar suits after their children were denied admission to preschools or nurseries.

The human rights court agreed that vaccine obligations place a burden on an individual, but it added that the societal benefits outweigh that burden.

The Czech Republic's laws require children to receive two combination vaccines to protect against a number of diseases, according to public broadcaster Czech Television.

Calling vaccines "one of the most successful and cost-effective health interventions" known to medicine, the court noted that the dynamics of herd immunity make it important to achieve a high rate of vaccination.

The inability of some children to be vaccinated for medical reasons, the court said, makes it more important to reach "a very high vaccination rate" to protect against contagious diseases.

Thursday's decision is the first time the European rights court has ruled on compulsory vaccinations, according to Deutsche Welle and other European media outlets.

In addition to ruling on privacy grounds, the court also rejected the argument from several of the plaintiffs that the EU's guarantee of freedom of religion and belief protects their position against the vaccines.

According to the ruling, the plaintiffs failed to prove their opinion about vaccines "was of sufficient cogency, seriousness, cohesion and importance so as to constitute a conviction or belief" under the European constitution's Article 9 protections.

All of the Czech cases were filed years before the COVID-19 pandemic, but the ruling comes as many countries — in Europe and around the world — look for ways to ensure their populations attain high vaccination levels. Many of those efforts are running up against skepticism, fueled by misinformation and concerns that the vaccines' development might have been rushed.

A large part of the U.S. population is also reluctant to receive COVID-19 vaccines: 1 in 4 Americans say they would refuse vaccination outright, according to a recent NPR/Marist poll.

A mass vaccination site in Commerce City, Colo., suspended operations Wednesday after almost a dozen people reported adverse reactions after getting their COVID-19 shots.

At least 11 people who received a Johnson & Johnson injection at the city's Dick's Sporting Goods Park said they experienced nausea and dizziness minutes after their jabs.

Medical staff determined that two people needed additional observation and were taken to nearby hospitals for further aid. The nine others who became sick were given juice and water before being cleared to go home.

State health officials quickly reassured the public, saying there's no reason for further concern for other people who were vaccinated that same day. The decision to pause operations at the site was done out of an abundance of caution, city officials said.

"We know it can be alarming to hear about people getting transported to the hospital, and we want to reassure Coloradans that the CDC and public health are closely monitoring all the authorized vaccines continually," said Scott Bookman, COVID-19 incident commander at the Colorado Department of Public Health and Environment. "From what we know, today's side effects were consistent with what can be expected."

A spokesman for Centura Health, which is administering the vaccination site with the state of Colorado, said the number of people who fell ill amounted to less than 1% of the 1,700 patients receiving shots that day.

The site had administered the Johnson & Johnson vaccine before, and problems are rare. The federally run Vaccine Adverse Event Reporting System reports there have been 10 previously documented reactions at community vaccine sites.

CDC Says More Virulent British Strain Of Coronavirus Now Dominant In U.S.

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On Wednesday, pharmacists at the West Wales General Hospital in Carmarthen, Wales, transport a cool box containing the first batch of Moderna vaccines being distributed in Britain. Jacob King/AP hide caption

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On Wednesday, pharmacists at the West Wales General Hospital in Carmarthen, Wales, transport a cool box containing the first batch of Moderna vaccines being distributed in Britain.

Jacob King/AP

A more easily spread coronavirus variant first identified in England last year has now become the dominant strain in the U.S., the head of the Centers for Disease Control and Prevention said Wednesday.

The variant, known as B.1.1.7, spread quickly across the United Kingdom and Ireland beginning last fall, with the more infectious version of the coronavirus thwarting restrictions and lockdowns that had earlier helped keep the original strain in check.

B.1.1.7 is "now the most common lineage circulating in the United States," CDC Director Rochelle Walensky said at a White House media briefing on Wednesday.

The announcement comes as the number of cases — particularly among younger Americans — has been on the rise in the U.S., fueling fears that the nation may be facing yet another deadly surge.

Walensky said that the newer strain has been shown to be more transmissible among younger people and that new outbreaks in the U.S. have been linked to youth sports and day care centers.

She urged people not to let their guard down and to get vaccinated as soon as possible. She said that communities and states with high levels of transmission need to curtail or suspend sports activities for younger participants to contain the spread of the new strain. She also said large events in affected communities needed to be curtailed.

"The virus still has a hold on us," she said. "We need to remain vigilant."

The CDC warned in January that B.1.1.7 would likely become the dominant strain of SARS-CoV-2 — the coronavirus that causes the disease COVID-19 — in the U.S. by the end of March.

Based on evidence gathered in the U.K., "it was predicted that this SARS-CoV-2 variant would dominate the USA within a matter of weeks. The prediction was indeed correct, and confirms that the work done in the UK was excellent," Jeremy Luban, a biochemist at the University of Massachusetts Medical School, said in an email to NPR.

Studies have suggested that the variant is about 50% more transmissible than the strain of the coronavirus first identified in China in December 2019.

Luban said that this could explain the sudden increase in cases in the United States.

"That being said, the more likely problem is that many states have opened up restaurants and other public indoor spaces, places where transmission rates are highest," he said.

The fact that the B.1.1.7 strain is more easily spread gives it the potential to kill more people.

"If you then crank that exponential growth up to a steeper curve, you very quickly start infecting many, many, many more people than you would have beforehand," epidemiologist Emma Hodcroft at the University of Bern in Switzerland said in January.

There is also evidence that this variant makes people sicker, says William Hanage, a professor of epidemiology at Harvard University.

Hanage said it was "inevitable" that the B.1.1.7 variant would become the dominant strain in the U.S. but expressed some optimism about the timing.

"[A]t least this is happening at a point when we have a decent amount of vaccination even if it is nowhere near enough to control B.1.1.7 on its own," he wrote in an email to NPR.

Hanage said two factors were driving down the mean age of hospitalizations in the U.S.: "the first is that older adults are vaccinated and so less likely to wind up in hospital."

The second factor, he said, "is that the younger age groups now being infected with B.1.1.7 are more likely to have severe disease, because the variant is more virulent."

The U.S. leads the world with nearly 31 million confirmed coronavirus cases since the start of the pandemic, with 556,000 deaths due to COVID-19.

EU Regulator: AstraZeneca Vaccine Effective; Blood Clots May Be A Rare Side Effect

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The European Union's drug regulator on Wednesday announced its findings into the possible connection between AstraZeneca's COVID-19 vaccine and rare blood clots. Jaap Arriens/NurPhoto via Getty Images hide caption

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The European Union's drug regulator on Wednesday announced its findings into the possible connection between AstraZeneca's COVID-19 vaccine and rare blood clots.

Jaap Arriens/NurPhoto via Getty Images

The European Union's drug regulator said Wednesday that the benefits of AstraZeneca's COVID-19 vaccine outweigh its risks, but that rare blood clotting events should be listed as a possible side effect.

The European Medicines Agency's assessment comes after a panel of experts reviewed reports of unusual blood clots occurring in some vaccine recipients. Officials stressed these events are rare and said that while they appear to be more common in women under the age of 60, there is not enough available evidence to confirm specific risk factors such as age, gender or previous medical history.

They said it is important for health care providers and the public to be aware of the signs and symptoms of these unusual events — which include shortness of breath, persistent abdominal pain and leg swelling — and that the vaccine's product information will be updated to list them as a possible adverse reaction. They are still recommending its use and emphasized the vaccine has been proven to prevent severe disease, hospitalizations and deaths.

"The risk of mortality from COVID is much greater than the risk of mortality from these side effects," said Emer Cooke, executive director of the European Medicines Agency. " I think it's important that we give the message that vaccines will help us in the fight against COVID, and we need to continue to use these vaccines."

In a statement, the agency said health care professionals and vaccine recipients should be aware of the "possibility of very rare cases of blood clots combined with low levels of blood platelets occurring within 2 weeks of vaccination."

The regulator's Pharmacovigilance Risk Assessment Committee noted that the recorded blood clots occurred in veins in the brain and abdomen, and in arteries, combined with low levels of blood platelets and "sometimes bleeding."

As of Sunday, the European Union's drug safety database had recorded 169 cases of blood clots in the brain, also known as cerebral venous sinus thrombosis, and 53 cases of those in the abdomen, or splanchnic vein thrombosis, in the European Economic Area and United Kingdom — where some 34 million people had received the vaccine.

Dr. Sabine Straus, the chair of the committee, said there was a "probable causal association" between the rare clots and the vaccine. It is too soon for the European Medicines Agency to identify a definite cause of the rare condition, conclusively determine risk factors or recommend any specific measures to reduce risk, officials said.

They noted that one plausible explanation for the combination of blood clots and low blood platelets is an immune response triggering a condition similar to one seen occasionally in patients treated with the blood thinner heparin.

The agency said it will continue to monitor the cases and issue new recommendations as necessary. It has also commissioned further research by AstraZeneca.

"This case clearly demonstrates one of the challenges posed by large-scale vaccination campaigns," Cooke said. "When millions of people receive these vaccines, very rare events can occur that were not identified during the clinical trials."

But it also demonstrates that the region's pharmacovigilance system works, she said, as the unusual events could be quickly identified, analyzed and acted on.

The U.K.'s Medicines and Healthcare products Regulatory Agency also put out additional findings on Wednesday drawing a "possible link" between the AstraZeneca vaccine and extremely rare blood clots.

It said the shot's benefits continue to outweigh any risk but advised "careful consideration" be given to individuals at higher risk of specific types of blood clots due to a medical condition.

It did not recommend age restrictions in the vaccine's use, but Britain's Joint Committee on Vaccination and Immunisation said the same day that it would be better, when possible, for adults under the age of 30 with no underlying conditions to be offered an alternative.

"We are not advising a stop to any vaccination for any individual in any age group," Wei Shen Lim, COVID-19 chair for that committee, said at a briefing, according to Reuters. "We are advising a preference for one vaccine over another vaccine for a particular age group, really out of the utmost caution, rather than because we have any serious safety concerns."

Last month, reports emerged of dozens of blood clots occurring after vaccination, several of them fatal. That prompted more than a dozen countries, mostly in Europe, to suspend temporarily use of the AstraZeneca vaccine, though the European Medicines Agency and World Health Organization both continued to recommend its use.

Many of those countries resumed inoculations after a European Medicines Agency investigation last month found that the vaccine's benefits far outweigh its risks, with officials pointing out the number of "thromboembolic events" reported after vaccination was actually lower than expected in the general population.

The regulator announced on March 18 that its preliminary investigation had determined the vaccine to be safe and effective, and said there is no increase in the overall risk of blood clots associated with its use, even as some questions remained.

Several of the countries to resume AstraZeneca vaccinations have done so with conditions; for example, French health authorities are recommending it only for people ages 55 and older, Germany suspended the "routine use" of the vaccine for people under 60 and South Korea said Wednesday it will temporarily withhold the vaccine from people under 60.

And on Tuesday, the University of Oxford announced it was pausing a small trial in the U.K. that would test the vaccine on individuals ages 6 to 17 as it waited for more data on the blood clotting reports.

The AstraZeneca vaccine has been approved by many countries across the world, and its affordability — at just $4 a dose — and minimal handling requirements make it ideal for global use, as NPR has reported.

The WHO in February approved the vaccine for emergency use to be rolled out globally through COVAX, an international effort to help low- and middle-income countries combat the pandemic. And the Biden administration said last month it was finalizing plans to loan millions of doses to Mexico and Canada.

It is not currently being used in the United States. The company has said it will seek emergency use authorization from the U.S. Food and Drug Administration, which would make it the fourth coronavirus vaccine available in the country.

That process has also raised some questions after an independent monitoring board said the company released data showing an incomplete picture of its efficacy. AstraZeneca then published results showing slightly diminished efficacy figures: 76% effective against symptomatic COVID-19 and 100% effective against severe or critical disease and hospitalization.

Dr. Anthony Fauci, the Biden administration's chief medical adviser, told Reuters earlier this month that the U.S. may not need it to vaccinate the entire population.

"My general feeling is that given the contractual relationships that we have with a number of companies, that we have enough vaccine to fulfill all of our needs without invoking AstraZeneca," Fauci said.

A coffin is buried at the Vila Formosa cemetery in Sao Paulo, Brazil, late last month. Brazil has been experiencing record numbers of coronavirus infections and COVID-19 deaths in recent weeks. Miguel Schincariol/AFP via Getty Images hide caption

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A coffin is buried at the Vila Formosa cemetery in Sao Paulo, Brazil, late last month. Brazil has been experiencing record numbers of coronavirus infections and COVID-19 deaths in recent weeks.

Miguel Schincariol/AFP via Getty Images

A new surge of COVID-19 in Brazil is filling hospitals and morgues, as the country's record daily death toll from the disease is nearing even the grim U.S. peak in January.

With less than two-thirds the population of the U.S., Brazil logged nearly 4,200 deaths on Tuesday. That is close to the peak U.S. daily death toll of 4,476 recorded on Jan. 12, according to data maintained by Johns Hopkins University.

Brazil is fighting a more easily-spread variant of the virus that has reportedly swept the nation in recent months.

Brazil's federal government has left it to the states to control the virus, but the country's right-wing president, Jair Bolsonaro, has been openly hostile to restrictions, which he says have damaged the economy. His supporters have also taken to the streets to protest quarantine measures.

Supporters of Brazilian President Jair Bolsonaro protest the start of a 10-day period of increased restrictions, which includes Holy Week, to help curb the spread of COVID-19, on Copacabana beach in Rio de Janeiro, Brazil, last month. Silvia Izquierdo/AP hide caption

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Silvia Izquierdo/AP

Supporters of Brazilian President Jair Bolsonaro protest the start of a 10-day period of increased restrictions, which includes Holy Week, to help curb the spread of COVID-19, on Copacabana beach in Rio de Janeiro, Brazil, last month.

Silvia Izquierdo/AP

One local mayor told NPR last month that she has received death threats for instituting a partial lockdown in her city.

Intensive care units across the country have been operating at near capacity for weeks, and officials are warning that the pandemic is quickly overwhelming health care infrastructure. A bulletin issued by the Brazilian medical research institution Fiocruz on Tuesday said that the lethality of coronavirus has more than doubled to 4.2% from around 2% at the end of 2020. Fiocruz attributes the increased death rate to the inability to quickly and correctly diagnose serious cases of COVID-19 and to overloaded hospitals. It warns of the "collapse of the health care system."

Bolsonaro, much like former U.S. President Donald Trump, has long downplayed the pandemic and promoted discredited treatments, namely the anti-malarial drug hydroxychloroquine, which scientists have said is useless in preventing or treating coronavirus. Also like Trump, the Brazilian president was himself once infected with the virus.

Bolsonaro, a retired army captain, marked his 66th birthday last month by appearing outside the presidential palace to greet supporters. Before a cheering crowd, he yanked off his face mask and laid into governors and mayors for imposing quarantine measures.

"Some little tyrants, or tyrants, hinder the freedom of many of you," Bolsonaro told the crowd.

On Tuesday, Bolsonaro again criticized lockdowns, suggesting without evidence that they caused obesity and depression, the BBC reported.

Meanwhile, Brazil's government has been slow to acquire lifesaving vaccines as Bolsonaro has been accused of politicizing the vaccine process.

Brazil lags behind many other countries in the percentage of its citizens inoculated against coronavirus, with less than 3% fully vaccinated, according to Bloomberg.

Although several South American countries have similarly low rates of inoculation thus far, Chile stands in marked contrast, with 21.5% of its population fully vaccinated.

Police officers stand guard during a night curfew designed to limit the spread of the coronavirus in New Delhi. The national capital has imposed a 10 p.m. to 5 a.m. curfew until April 30. Mayank Makhija/NurPhoto via Getty Images hide caption

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Police officers stand guard during a night curfew designed to limit the spread of the coronavirus in New Delhi. The national capital has imposed a 10 p.m. to 5 a.m. curfew until April 30.

Mayank Makhija/NurPhoto via Getty Images

MUMBAI — India confirmed another record jump in COVID-19 cases Wednesday, as the world's biggest vaccine maker said it was "very stressed" and needs help from the Indian government to boost production.

India is struggling to speed up vaccinations amid its sharpest spike in coronavirus infections since the pandemic began. Authorities are also trying to balance stricter curbs on movement while also ensuring fair voting in five regions holding state elections throughout the month.

Despite bans on large gatherings in other parts of India, Prime Minister Narendra Modi appeared in person at several political rallies Tuesday in West Bengal, one of the jurisdictions voting this month. Modi's Bharatiya Janata Party hopes to make inroads in West Bengal — one of the last bastions of opposition rule.

India has administered nearly 90 million vaccine doses so far. But that's still less than 6% of the population of nearly 1.4 billion. Modi got his first dose of a coronavirus vaccine on March 1.

In an interview with local TV, the CEO of the Serum Institute of India, Adar Poonawalla, said late Tuesday that his company's production of the Oxford-AstraZeneca vaccine, the injection most used in India, is "very stressed, to put it frankly."

"We are prioritizing the needs of India, but we are still short of being able to supply to every Indian," Poonawalla said.

He said he planned to take out bank loans if the Indian government does not respond to his request for about $400 million in order to meet its requirements.

After touting its ability to export millions of doses of coronavirus vaccines, India in recent weeks has diverted some of those shipments for use domestically. Other countries have complained that their vaccine orders from India have been delayed.

The Health Ministry on Wednesday confirmed 115,736 new infections and 630 deaths — India's highest death toll since November.

About half of the new cases are in the western state of Maharashtra, where Mumbai is the state capital. Hospitals there are running out of beds, oxygen and medicines. Apartment complexes where residents test positive are being sealed off and guarded by police.

Mumbai and the national capital Delhi both remain under night curfews. The Delhi High Court said Wednesday that masks are compulsory – even if a person is driving alone in their own car. Gatherings are banned, and officials have closed Mumbai's beaches and other areas where crowds may gather.

But restaurants, shops — even cinemas — remain open in most of India. Officials have held off declaring a strict nationwide lockdown. Last spring, India's economy shrank nearly 24% under nationwide restrictions, and there were cases of starvation among the poor.

The chief ministers of Maharashtra and New Delhi have instead asked Modi's government to lift age requirements and speed vaccinations to adults of all ages. But the central government has so far refused. Only people 45 or older, and some categories of frontline workers, remain eligible.

A crowd of parents and children at a playground during the COVID-19 pandemic in Toronto on April 4. Canada is experiencing a third wave of the coronavirus pandemic. Creative Touch Imaging Ltd./NurPhoto via Getty Images hide caption

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A crowd of parents and children at a playground during the COVID-19 pandemic in Toronto on April 4. Canada is experiencing a third wave of the coronavirus pandemic.

Creative Touch Imaging Ltd./NurPhoto via Getty Images

A resurgence of COVID-19 cases driven by virus variants throughout Canada has forced the country's largest city to suspend in-person learning.

All elementary and secondary school students in Toronto will return to remote learning Wednesday without the chance to return before April 18, city officials announced Tuesday.

"The spread of COVID-19 has never been greater in Toronto, with variants of concern increasing both the risk of transmission and the risk of serious illness or death," a press release announcing the measure said. "Stronger public health measures are required to reverse the surge of infection that the province currently faces."

City leaders indicated the order may be extended if cases do not drop.

Dr. Theresa Tam, the chief public health officer for Canada, said Tuesday the latest COVID-19 surge stems from contagious variants in many areas of the country.

"With an ongoing increase in severe and critical illnesses placing a heavy strain on the health system in many places, it is clear community-based restrictions will be needed a while longer," she said in a statement.

Since the start of the pandemic, Canada has recorded more than 1 million COVID-19 cases and more than 23,000 reported deaths. Over the past week, experts have seen an average of 6,100 new cases and 31 deaths reported daily, Tam said.

"With increasing rates of infection, we are seeing a greater number of younger adults with COVID-19 being treated in hospital," Tam said. "This is a reminder that COVID-19 can impact people of all ages and severe illness can occur at any age."

Hospitalizations are up 4% from the previous week, and the rate of intensive care unit admissions has risen 18%, she said. The B.1.1.7 variant, which causes more severe illness and is considered more deadly, continues to account for more than 90% of COVID-19 variant cases, she said.

Tam urged Canadians to limit their travel as much as possible as health officials try to curtail the spread of the third wave.

The Santa Monica Pier welcomed outdoor visitors on Monday as Los Angeles County entered the less-restrictive orange tier. The following day, California Gov. Gavin Newsom announced a target statewide reopening date of June 15, provided certain public health criteria are met. Myung J. Chun/Los Angeles Times via Getty Images hide caption

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Myung J. Chun/Los Angeles Times via Getty Images

The Santa Monica Pier welcomed outdoor visitors on Monday as Los Angeles County entered the less-restrictive orange tier. The following day, California Gov. Gavin Newsom announced a target statewide reopening date of June 15, provided certain public health criteria are met.

Myung J. Chun/Los Angeles Times via Getty Images

California could lift most statewide COVID-19 restrictions by June 15 if vaccine supply is sufficient and hospitalizations are low, Gov. Gavin Newsom announced on Tuesday.

Newsom said the state would lift its tiered system of risk and restriction, known as the Blueprint for a Safer Economy, contingent on those public health indicators, with its mask mandate and other "commonsense health measures" to remain in place.

"We are seeing bright light at the end of the tunnel," Newsom said at a news conference. "And on June 15, all things being equal and we continue that good work, we'll have moved beyond that blueprint and we'll be opening up this economy at business as usual."

He stressed that Californians should remain vigilant, especially given the relatively high case count of coronavirus variants recorded in the state. But he said California could soon be ready to take another step in its pandemic recovery, citing the lower number of hospitalizations and an expected increase in the availability of vaccines provided by the federal government.

The state crossed two important thresholds on the day of the announcement, according to Newsom: It has administered 20 million doses, including 4 million under its health equity metric.

He said officials are designing a system that will be able to administer some 5.8 million doses on a weekly basis, more than double the capacity of the approximately 2.5 million it received last week from the federal government. That number is expected to increase, with Newsom anticipating that more than 30 million doses will have been administered by the end of the month.

Eligibility for the vaccine is also increasing. People age 50 and older became eligible for the vaccine on April 1 and will be joined by those 16 and up starting on April 15. The state has administered over 7 million more doses than any other U.S. state, Newsom said.

"With more than 20 million vaccines administered across the state, it is time to turn the page on our tier system and begin looking to fully reopen California's economy," Newsom said. "We can now begin planning for our lives post-pandemic."

The state will continue contact tracing and testing, and testing or vaccination verification requirements will remain in certain settings, he said in a news release. He cautioned that the tentative plan is subject to vaccine supply and hospitalization rates, adding that officials will monitor those metrics "with the option to revisit" the target date if needed, though he did not specify any numbers.

Dr. Mark Ghaly, California's health and human services secretary, said officials would pay close attention not just to the rate of hospitalizations but to who exactly is being admitted and how many patients had already been vaccinated.

While the number of hospitalizations is low across the state — with 20 patients currently hospitalized with COVID-19 in San Francisco, for example — Ghaly said there is a race between vaccines and variants, and he urged the public to take public health precautions like wearing a mask and signing up for the vaccine once eligible.

California's public health department said the statewide seven-day positivity rate was 1.6% as of Monday. As of the Blueprint for a Safer Economy's latest update on Tuesday, the majority of the state's counties are in the "substantial" or "moderate" tiers of risk, with two classified as "widespread" and two as "minimal."

In a memo outlining the transition, state public health officials said business sectors will be able to return to usual operations with "limited" public health restrictions.

Unless testing or vaccination status is verified for all attendees, conventions will be capped at 5,000 people until Oct. 1, and international convention attendees will be allowed only if fully vaccinated.

Schools and institutions of higher education should conduct full-time, in-person instruction in compliance with state and federal health guidelines, the memo added. Newsom said there is an expectation that students will return to in-person learning but stopped short of calling it a requirement.

Californians and visitors will be subject to state and federal travel restrictions, which have also eased slightly in recent days, though nonessential trips remain discouraged.

The state's updated travel advisory as of April 1 no longer includes a recommendation that Californians not travel more than 120 miles from their place of residence, though it continues to discourage nonessential travel outside the state.

The announcement comes as the governor faces political pressure from a recall effort that he dismissed last month as partisan and Republican. Critics of Newsom have taken issue with his handling of the pandemic and business restrictions and are frustrated by worsening housing and homelessness issues and high taxes, as CapRadio reports.

It's one of several such efforts to have been filed since Newsom was reelected in 2018, and it would be California's first gubernatorial recall in nearly two decades. Organizers said they had collected enough signatures by the mid-March deadline to force a special election, and county election officials have until the end of the month to verify them.

People wait in their vehicles to get vaccinated last week at a drive-through site at Hard Rock Stadium in Miami Gardens, Fla. President Biden announced an April 19 deadline for all states to open eligibility to individuals ages 18 and up. Chandan Khanna/AFP via Getty Images hide caption

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Chandan Khanna/AFP via Getty Images

People wait in their vehicles to get vaccinated last week at a drive-through site at Hard Rock Stadium in Miami Gardens, Fla. President Biden announced an April 19 deadline for all states to open eligibility to individuals ages 18 and up.

Chandan Khanna/AFP via Getty Images

President Biden announced Tuesday that he is moving up the deadline for states to open up COVID-19 vaccinations to all U.S. residents 18 and older by about two weeks. Less than a month after directing states to expand eligibility to all adults by May 1, Biden changed that deadline to April 19.

"No more confusing rules, no more confusing restrictions," Biden said.

The president made his announcement after visiting a vaccination site at Virginia Theological Seminary in Alexandria, an Episcopal institution founded in 1823. His visit was intended to highlight the participation of religious organizations in the vaccination effort.

Most states have either made vaccines available to all residents 16 and older or announced plans to do so by mid-April. The White House did not say how it intends to get the handful of remaining states to move up their timelines.

Officials announced at the end of March that nearly half of states were set to expand eligibility to all adults by April 15, and that 46 states and Washington, D.C., would do so by May 1. In the weeks since, the remaining four states — New York, Wyoming, South Carolina and Arkansas — have all opened vaccines to the general public.

Biden also announced that the U.S. administered 150 million doses in his first 75 days in office, a pace that puts the administration on track to surpassing his previously stated goal of reaching 200 million doses in his first 100 days.

The country is averaging 3.1 million shots per day over a seven-day period, White House officials said Monday, and reached a new milestone over the weekend with an unprecedented 4 million vaccinations recorded in one day. Nearly 1 in 4 adults are fully vaccinated, officials added.

According to NPR's vaccine tracker, 18.8% of the U.S. population is fully vaccinated, and 32.4% has had at least one dose. The states with the highest percentage of their populations vaccinated include New Mexico, South Dakota, Alaska, Rhode Island and Maine.

A woman wearing a protective mask to help curb the spread of the coronavirus walks in front of he Olympic Rings on Tuesday in Tokyo. North Korea says it will not attend the games over COVID-19 fears. Eugene Hoshiko/AP hide caption

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Eugene Hoshiko/AP

A woman wearing a protective mask to help curb the spread of the coronavirus walks in front of he Olympic Rings on Tuesday in Tokyo. North Korea says it will not attend the games over COVID-19 fears.

Eugene Hoshiko/AP

North Korea says it will skip the upcoming Summer Olympics in Tokyo, citing coronavirus concerns – a move that frustrates South Korea's hopes that the games might revive stalled peace talks between the bitter rivals.

The decision to sit out the already delayed Tokyo Games means the North's athletes will be a no-show at the Olympics for the first time since Pyongyang boycotted them in 1988, the year they were held in Seoul.

The North's Olympic Committee "decided not to participate in the 32nd Olympic Games during the [March 25] general assembly to protect our athletes from the global health crisis situation related to the coronavirus as proposed by committee members," according to a translation by South Korea's Yonhap news service of the announcement on an official state-run website devoted to sports affairs in North Korea.

Pyongyang's decision in 2018 to send nearly two dozen athletes; government officials including leader Kim Jong Un's influential sister, Kim Yo Jong; journalists; and even a cheering squad with more than 200 members to the Winter Games in South Korea helped break a diplomatic logjam that led to a brief rapprochement with Seoul and Washington.

South Korea's Unification Ministry expressed regret over the North's latest decision, saying it had hoped the Olympics would be an opportunity for improving inter-Korean relations.

North Korea claims to have no confirmed coronavirus cases or COVID-19 deaths. Although Pyongyang has a history of little to no transparency about what is happening inside the country, some outside experts believe the country's near-total isolation and aggressive lockdowns have likely helped spare it from the worst of the pandemic, to the detriment of its economy.

Victor Cha, senior vice president and Korea chair at the Center for Strategic and International Studies and a professor at Georgetown University, told NPR's Here & Now in February that North Korea "is quite paranoid on a good day, but right now they are extremely paranoid about COVID getting into the country."

He said while it's hard to know what is going on in the country, "it's certainly plausible that there are no cases inside the country, because they have sealed the border for more than a year."

A South Korean Foreign Ministry spokesman, Choi Young-sam, said it was not too late for Pyongyang to reverse its decision.

However, Park Won Gon, a professor of North Korea studies at Seoul's Ewha Womans University, told The Associated Press that it's unlikely the North would change its mind about the Games, given the low probability that it can secure enough vaccine to inoculate its population of 26 million by the time the events begin.

The North has shown "a coronavirus-related neurosis since it declared an emergency anti-virus system in January last year," Park said.

The Olympics have already been postponed a year due to the pandemic. Despite speculation that they might be delayed yet again, Tokyo's organizing committee has maintained adamantly that they will begin as planned on July 23. North Korea's move makes it the first major country to say it is skipping the games as a result of the pandemic.

Japan's chief Cabinet secretary, Katsunobu Kato, said Tokyo expressed hope that many countries would attend the Olympics and promised measures to minimize the danger of the spread of the virus, according to the AP.

Even so, organizers have banned overseas spectators from the Olympic and Paralympic Games this year as a precaution against spreading the coronavirus.

The novel coronavirus, first detected at the end of 2019, has caused a global pandemic.

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