Coronavirus cases and hospitalizations are surging in Pennsylvania, as state officials warn of the impact of trends seen across the country: increased travel, relaxing restrictions and the spread of more contagious virus variants.
Pennsylvania is reporting an average of 4,922 cases a day, up from roughly 2,515 a month ago, according to a New York Times database. Hospitalizations have also climbed by about 16 percent in the past two weeks, and the state now has one of the highest per capita daily case counts in the United States. Deaths, which tend to lag behind infections by weeks, have started to increase again after plunging from the state’s high of an average of 222 in mid-January, now averaging about 37 a day.
State and national health officials are also worried about the spread of more contagious virus variants, particularly the B.1.1.7 variant first found in Britain. That variant is estimated to be about 60 percent more contagious and 67 percent more deadly than the original version.
B.1.1.7 is now the most common source of new coronavirus infections in the United States. Data from the Centers for Disease Control and Prevention show that 28 percent of Pennsylvania’s cases involve that variant, and it is spreading in a vast majority of two dozen other states with high caseloads. In Michigan, more than 57 percent of cases involve B.1.1.7; in Tennessee, the figure is over 60 percent.
New Jersey and New York, where the variant accounts for roughly 30 percent of cases, endured difficult starts to the spring, but they are starting to see case counts drop.
Although nearly all of Pennsylvania’s counties are “at a high level of risk transmission,” Alison Beam, Pennsylvania’s acting health secretary, said the state did not have plans to impose new lockdowns. She urged people to continue wearing masks, social distancing and getting vaccinated.
“At this stage, our hospitals have not indicated to us that they are overrun or that they foresee being overrun,” Ms. Beam said. “That will be truly one of our key gauges of when any further mitigation effort would need to be even contemplated.”
James Garrow, the communications director of the Philadelphia Department of Public Health, said the number of cases in the city appeared to be growing as restrictions gradually lift. If the city continues on this path for another month, officials will “seriously discuss” imposing fresh regulations to keep hospitalizations down, he said.
Dr. John Zurlo, the division director of infectious disease at Jefferson Health in Philadelphia, said that he had seen a steady increase in Covid-19 hospitalizations in the past six weeks, and that most patients were now in the younger 45 to 64 age group. A vast majority of those patients had not been vaccinated, he said. Like most states, Pennsylvania prioritized vaccinating older people but opened up eligibility to all adults on Tuesday.
And Pennsylvania’s vaccination campaign is ahead of most states. About 43 percent of the state’s population has received at least one shot, including roughly 26 percent who have been fully vaccinated, according to data from the C.D.C. Nationally, 39 percent of the population has received at least one shot, and 25 percent have been fully vaccinated.
But many health officials have warned about the lingering challenge of persuading all eligible people to get vaccinated. For instance, in one Pennsylvania county, a hospital set up a drive-through in a park stocked with roughly 1,000 vaccine doses. Only about 300 people showed up. In Iowa, a rural clinic called people who had volunteered to give shots to tell them not to come in because so few residents had signed up for appointments.
The New York Times examined survey and vaccine administration data for nearly every U.S. county and found that both willingness to receive a vaccine and actual vaccination rates to date were lower, on average, in counties where a majority of residents voted to re-elect President Donald J. Trump in 2020. The phenomenon has left some places with a shortage of supply and others with a glut.
Just a day after extending and expanding its stay-at-home orders, Ontario — Canada’s most populous province — limited sweeping new powers that it had granted to the police to enforce the mandates in an effort to curb rising case numbers and hospitalizations.
On Friday, Doug Ford, the premier, announced that the police would be able to randomly stop and question people, including those in vehicles, to make sure that their trips outside home were essential. Anyone outside their home and not following the rules could face fines.
While polls suggest that there is general public support for restrictions throughout Canada, Mr. Ford’s plan for the police to conduct random checks immediately provoked a backlash.
In announcing that his organization would begin a legal challenge on Saturday, Michael Bryant, the president of the Canadian Civil Liberties Association, said in a statement that “the regulation brings back the odious ‘driving while Black’ police stop, and introduces a ‘walking while Black’ offense.”
On Saturday evening, Sylvia Jones, the province’s solicitor general, said in a statement that rules had been modified to allow the police to question only people they believe are “participating in an organized public event or social gathering.” The current restrictions allow only members of the same household to meet outside their homes with some exemptions for events like funerals.
In a statement on Saturday, Mr. Bryant said that his group accepted the new plan, because it was “tied to a public health objective and avoids arbitrary detention.”
On Friday, the Ontario government said it would restrict travel between neighboring Manitoba and Quebec, and it would set up checkpoints at the provincial borders.
The new measures come amid a sluggish vaccine campaign in Canada and the latest virus wave there, driven largely in Ontario by the highly contagious B.1.1.7 variant first detected in Britain. The increasing case numbers have strained the capacity of intensive care units in many parts of the country.
Canada has inched ahead of the United States in new daily coronavirus cases per capita, and officials warned that worse is to come. By Friday, hospitalizations were up by 22 percent; I.C.U. admissions rose by 34 percent; and each day, 41 people died from Covid-19, a 38 percent increase from the previous week.
“It now falls on me to do what is necessary,” Mr. Ford said on Friday, adding that aside from restricting border crossings with Manitoba and Quebec, he was also closing playgrounds, golf courses, basketball courts and other outdoor sports facilities, along with a variety of other measures. On Saturday, Mr. Ford wrote on Twitter that the regulations would be changed to allow playgrounds to reopen. Schools were closed during the past week for a delayed March break. But the government had said on Monday that they would remain closed for in-person learning indefinitely.
The measures announced on Friday were met with criticism, including from public health experts, the mayor of Toronto and several police departments, including the Toronto Police Service, which said on Twitter that it would “not be doing random stops of people or cars.” There were also concerns that asking the police to impose such measures could result in racial profiling.
“I know you are all sick and tired of Covid-19,” Prime Minister Justin Trudeau said on Friday as he urged Canadians to follow their provinces’ rules. “We all just want to be done with this.”
Emergency rooms, particularly in Ontario, are reaching their breaking points, as are intensive care units. In a bid to ease the strain, children’s hospitals in both Ottawa and Toronto opened their I.C.U. beds to adults.
Many factors are behind the increasing numbers. Among them is the arrival of more infectious variants of the virus. An outbreak of P.1, the variant first found in Brazil, spread throughout British Columbia and then into Alberta. Manitoba discovered its first case of the variant this week.
And the vaccine campaign has taken a hit: Moderna is cutting deliveries of its vaccine shipment to Canada and other countries, and the Johnson & Johnson vaccine, which has yet to arrive in Canada, has come under safety scrutiny.
Pfizer will sell Canada an additional eight million doses of the vaccine it has developed with BioNTech, half of which will arrive next month, and all of which will arrive by the end of July.
Many Canadians are frustrated as they see higher vaccination rates in Britain and the United States.
Canada’s vaccination strategy has been to delay second doses to allow more residents to gain the protection from at least one shot. About 2 percent of Canadians are fully vaccinated compared with 25 percent of Americans, and 19 percent have received at least one dose compared with 39 percent in the United States. Yet the scheduled increases in vaccine shipments — the Moderna slip up aside — should help Canada catch up over the next few weeks.
Farah Mohamed contributed reporting.
Three million lives: That is roughly equivalent to losing the population of Berlin, Chicago or Taipei. The scale is so staggering that it sometimes begins to feel real only in places like graveyards.
The world’s Covid-19 death toll surpassed three million on Saturday, according to a New York Times database. More than 100,000 people have died from Covid-19 in France. The death rate is inching up in Michigan. Morgues in some Indian cities are overflowing with corpses.
And as the United States and other rich nations race to vaccinate their populations, new hot spots have emerged in parts of Asia, Eastern Europe and Latin America.
The global pace of deaths is accelerating, too. After the coronavirus emerged in the Chinese city of Wuhan, the pandemic claimed a million lives in nine months. It took another four months to kill its second million, and just three months to kill a million more.
A year ago, the United States government made a big bet on plasma.
The Trump administration, buoyed by proponents at elite medical institutions, seized on it as a good-news story at a time when there weren’t many others. It awarded more than $800 million to entities involved in its collection and administration, and put Dr. Anthony S. Fauci’s face on billboards promoting the treatment. Companies and nonprofit groups, with celebrity help, urged people who had recovered from Covid-19 to donate, and volunteers, some dressed in superhero capes, showed up to blood banks in droves.
No one knew if the treatment would work, but it seemed biologically plausible and safe, and there wasn’t much else to try.
But by the end of the year, good evidence for convalescent plasma had not materialized, prompting many prestigious medical centers to quietly abandon it. By February, with cases and hospitalizations dropping, demand dipped below what blood banks had stockpiled.
All told, more than 722,000 units of plasma were distributed to hospitals thanks to the federal program, which ends this month.
Because the government gave plasma to so many patients outside of a controlled clinical trial, it took a long time to measure its effectiveness. Eventually, studies did emerge to suggest that under the right conditions, plasma might help. But enough evidence has now accumulated to show that the country’s broad, costly plasma campaign has had little effect, especially in people whose disease is advanced enough to land them in the hospital.
The government’s bet did not result in a blockbuster treatment, or even a decent one, for Covid-19. But it did give the country a real-time education in the pitfalls of testing a medical treatment in the middle of an emergency. Medical science is messy and slow. And when a treatment fails, which is often, it can be difficult for its strongest proponents to let it go.
HARARE, Zimbabwe — Zimbabwe released at least 320 prisoners from its jails on Saturday to ease congestion in the country’s notoriously overcrowded jails as a second wave of the coronavirus devastates the country.
The move comes amid growing allegations that a government crackdown has sent dozens of activists, journalists and opposition leaders to prisons.
The prisoners were released under an amnesty program established by President Emmerson Mnangagwa in 2018, the year after he seized power, ending decades of the strongman rule of Robert G. Mugabe. The amnesty does not include prisoners convicted of crimes that include murder, human trafficking, sexual offenses and treason.
Most of those released on Saturday had been convicted of nonviolent crimes, according to Zimbabwe’s Prison and Correctional Service, but were being held in the infamous Chikurubi Maximum Security Prison. That is the country’s largest correctional facility, and it is known for overcrowding and unsanitary conditions.
For years, Zimbabwean officials have grappled with severely strained jails that human rights organizations have slammed for unsafe conditions. The country’s prisons have the capacity to house 17,000 prisoners at most, but they held around 22,000 when Mr. Mnangagwa established the amnesty.
Concerns about prison overcrowding grew more urgent when the pandemic struck last year, and the virus threatened to engulf the prison population. From March 2020 to June 2020, the government released 4,208 prisoners under the amnesty order.
The decision to release the latest round of prisoners comes after the variant first identified in South Africa, B.1.351, flooded into Zimbabwe at the start of the year, straining a system that already lacked enough drugs, equipment and medical staff. To date, Zimbabwe has recorded nearly 38,000 coronavirus infections, including 1,551 deaths, according to the Africa Centers for Disease Control and Prevention.
In February, the country started a national vaccine campaign with 200,000 doses donated by the Chinese vaccine maker Sinopharm. The country is set to receive an additional 1.1 million doses as part of Covax, a global sharing program that is distributing vaccines to poor and middle-income countries.
Zimbabwean officials have portrayed the vaccine rollout as a major win in the government-led response to the pandemic. But in recent months, human rights organizations have accused leaders of using coronavirus restrictions as a pretext to arrest opposition leaders in a crackdown on dissent.
The crackdown stretches back to at least last summer, when security services shut down the capital, Harare, and arrested several government critics in response to planned protests over alleged corruption and the government’s mismanagement of the coronavirus pandemic. Dozens of opposition activists have gone into hiding since.
A U.S. State Department human rights report released last month accused Zimbabwe’s security forces of engaging in serious human rights violations last year — including arbitrary killing and torturing of civilians. The report also noted harsh and life-threatening conditions for political prisoners and detainees inside the country’s prisons.
On Saturday, human rights investigators commended the latest release of some prisoners and called on the Zimbabwean government to expand upon the initiative immediately.
“The Zimbabwe authorities should also release those in pretrial detention for nonviolent and lesser offenses, many of whom are political activists whose continued detention is unnecessary and unjustified,” said Dewa Mavhinga, Southern Africa director of Human Rights Watch.
Queen Elizabeth II, wearing a black face mask and seated alone, said goodbye to her husband of more than 73 years, Prince Philip, the Duke of Edinburgh, at his funeral on Saturday at St. George’s Chapel in Windsor Castle.
The ceremony for Prince Philip, who died last week at age 99, was highly unusual — in part because coronavirus restrictions meant that it had to be scaled back, but also because it followed a very public airing of a family rift.
Only 30 guests attended the church service. The queen and select family members in attendance all wore masks and were seated six feet apart in the chapel.
The subdued service still reflected Philip’s own wishes for the ceremony, Buckingham Palace said. The prince was deeply involved in the organization of the event, which was years in the planning.
The Grenadier Guards, a centuries-old regiment of the British Army, which the Duke of Edinburgh served as a colonel for more than four decades, placed his coffin on a hearse that the prince helped design. The vehicle, a modified Land Rover Defender, then led a small procession toward the chapel.
There was much speculation about how the family dynamic would play out, as the funeral is the first time that Prince Harry has returned to Britain since stepping down as a senior royal. The service also came just weeks after he and his wife, Meghan, the Duchess of Sussex, gave a bombshell interview to Oprah Winfrey in which they laid bare their problems with the royal family.
The funeral service lasted less than an hour. A choir of four sang music chosen by Prince Philip but were some distance from the seated guests, in line with public health guidelines.
Five months before the regular season starts, the N.F.L. and its players are facing their first clash over playing in the pandemic, with players for nearly half of the teams vowing to skip voluntary off-season workouts.
Players on 14 of the league’s 32 teams, including the Giants, the Jets and the Super Bowl champion Tampa Bay Buccaneers, said in statements released by the N.F.L. Players Association that they would not participate in the workouts scheduled to begin on Monday because of concerns it would be unsafe to gather.
Buccaneers quarterback Tom Brady was among the players who spoke to the news media and on social media.
“We feel very strongly about the game, the short- and long-term health of the players, and there is no game without strong, healthy players,” Brady said in a conference call with The New York Times and the union’s leadership. “People within the league may think, ‘Oh, let’s just get back to business, let’s go back to what we’ve usually done.’ But I think it’s really smart for people and players to think, ‘Is this the best possible way to do things?’”
The N.F.L. declined to comment.
The union has called for a virtual off-season — essentially players working out on their own away from team complexes — similar to what took place in 2020. Although a nationwide vaccine campaign is underway, the union argues that the danger is still high.
Last season, the N.F.L. shifted its off-season program to a virtual format, with the only in-person work happening at training camps in August. This spring, the union asked the league to use a similar format, while allowing for a mandatory minicamp in June. The league declined, citing protocols that it said would allow the workouts to occur safely.
Medical scientists say that although the complications of Covid-19 have riveted people’s attention, many symptoms — like a loss of smell — are not unique to the disease. Heart inflammation, lung and nerve damage and small blood clots in the lining of lungs occur in a small but noticeable percentage of patients who have had other respiratory and viral infections. These patients can have their own version of “long Covid.”
No one is saying Covid-19 is the equivalent of, say, the flu that circulates each year. The usual seasonal flu has not killed millions worldwide in a single year, and more than half a million Americans, while upending society and ravaging economies. But Covid-19 is providing a new opportunity to understand the complications of many common viral infections.
Researchers want to know who is susceptible to heart infections, blood clots or lung damage after having a respiratory virus like the flu. For the most part, little is known. Part of the problem was that only a minority of patients with respiratory viruses were affected with these conditions, and until the coronavirus, that tended not to be a big number. Many of these effects were noticed but then forgotten.
All through last year, as Europe and then the United States suffered high coronavirus infections and deaths, Pacific Rim countries staved off disaster through an array of methods. South Korea tested widely. Australia and New Zealand locked down. In Japan, people donned masks and heeded calls to isolate.
Now, the roles are reversed.
The countries that have largely subdued the virus are among the slowest in the developed world to vaccinate their residents, while countries like Britain and the United States are leapfrogging ahead with inoculations.
The United States has fully vaccinated close to a quarter of its population, and Britain has given first shots to nearly half of its residents. By contrast, Australia and South Korea have vaccinated less than 3 percent of their populations, and in Japan and New Zealand, not even 1 percent of the population has received a shot.
To some extent, the laggards are taking advantage of the luxury of time that their comparatively low infection and death counts afford. And they all rely on vaccines developed — and, for now, manufactured — elsewhere.
But the delays risk unwinding their relative public health successes and postponing economic recoveries, as contagious virus variants emerge and bottlenecks slow shipments of vaccines around the world.
The Biden administration on Friday lifted restrictions on the use of fetal tissue for medical research, reversing rules imposed in 2019 by President Donald J. Trump.
The new rules, disclosed by the National Institutes of Health, allow scientists to use tissue derived from elective abortions to study and develop treatments for diseases including diabetes, cancer, AIDS and Covid-19.
The Department of Health and Human Services, which oversees the N.I.H., essentially restored the guidelines in place during the Obama administration. Scientists may purchase fetal tissue from sources approved before the ban, and all projects that had been approved before the Trump administration’s restrictions will be reinstated.
The ban’s reversal fulfilled a promise made by the Biden administration to support science, and dismayed conservative groups that oppose fetal tissue research as violating the sanctity of life.
An 18-year-old woman was stricken with severe headaches, vomiting, seizures, confusion and weakness in one arm early this month, strokelike symptoms that doctors at a Nevada hospital were shocked to see in someone so young.
Scans found several large blood clots blocking veins that drain blood from the brain, a condition that can disable or kill a patient.
Doctors performed a procedure to suction huge clots from her brain, only to find that new ones had formed.
The patient is one of six women ages 18 to 48 who developed clots in the brain within two weeks of receiving the Johnson & Johnson Covid-19 vaccine. One died, and their devastating cases led U.S. health officials to recommend on Tuesday that use of the vaccine be paused.
Dark windows. Quiet lobbies. Hushed halls.
With many of New York’s hotels and office buildings unoccupied for more than a year now — and questions over whether some will ever fill up again — an effort is afoot to convert some commercial structures into housing or other uses. The result could be a wave of building conversions not seen since the crash of the late 1980s.
From corporate high rises in the financial district to boutique lodgings near Central Park to mid-market accommodations in Midtown, real estate players are redeveloping or canvassing dozens of sites, according to those involved. The discussions fall into three categories: converting offices to housing, hotels to housing, and hotels to offices.
Eric Anton, an agent with the firm Marcus and Millichap who specializes in selling buildings, said that of the seven hotels in New York he represents, three are likely to become senior housing, one will become market-rate apartments and the balance will remain hotels.
“A lot of the conversations revolve around whether the conversions can happen efficiently,” Mr. Anton said.
Health officials in Colorado are warning about another wave of infections as new coronavirus cases in the state jump to levels not seen since January and as counties start to loosen virus restrictions.
The state is reporting an average of 1,661 new cases a day, up by 18 percent in the past two weeks, according to a New York Times database. Hospitalizations have climbed by 19 percent in the same time period. Deaths from the virus, which tend to lag behind infections for several weeks, have slightly increased.
“We are seeing what appears to be the beginning of a fourth wave of Covid-19 in Colorado,” Scott Bookman, the state’s Covid-19 incident commander, said at a news briefing on Thursday. He urged people to remain vigilant about getting tested as more of the state’s population becomes vaccinated.
As in many parts of the country seeing caseloads rise, health officials say the increase has been fueled in part by the spread of more contagious variants of the virus, particularly the B.1.1.7 variant first found in Britain. That variant is estimated to be about 60 percent more contagious and 67 percent more deadly than the original version. B.1.1.7 is now the most common source of new coronavirus cases in the United States, and tracking by the Centers for Disease Control and Prevention suggests that “variants of concern,” including B.1.1.7 and a variant that emerged in California, CAL.20C, now make up more than half of all new coronavirus cases in Colorado.
Even as cases mount, the state on Friday ended its “dial system” that required counties to place capacity limits on restaurants, offices and gyms, depending on case counts, positive test percentages and hospitalizations in those areas. That change shifted control of pandemic regulations to local counties, prompting concerns from some public health experts that the move could result in cases and hospitalizations continuing to rise. Several counties experiencing an increase in cases and hospitalizations, like El Paso and Douglas Counties, have said they do not plan to impose restrictions beyond those mandated by the state.
The state still requires counties to comply with its mask mandate — which will stay in place through May 2 — and with limits on indoor mass gatherings.
“I am concerned that without policies and behaviors to slow transmission,” said Elizabeth Carlton, an associate professor at the Colorado School of Public Health, “we will continue to see increases in Covid-19 hospitalizations among those who are not yet vaccinated.”
“It worries me,” Dr. Bill Burman, director of Denver Public Health, said about counties that were choosing to be more lax with restrictions. Denver eased some regulations on Friday but kept in place certain restrictions, like capacity limits on bars, offices and retail stores.
An analysis published this month and led by researchers at the Colorado School of Public Health found that delaying policy changes, at the state or local level, until mid-May would “prevent large numbers of deaths and hospitalizations.” According to the report, mobility in the state is also reaching its highest levels since the start of the pandemic.
State officials defended the change last week, pointing to the relatively low number of hospitalizations and deaths compared with the peaks seen in December. Gov. Jared Polis, a Democrat, said at a news briefing on Tuesday that he was confident that counties could take on greater responsibility, but he urged people to remain cautious.
“I think that the number of cases and hospitalizations will sadly continue to go up before it goes down,” Mr. Polis said, adding that he hoped it would be a short peak as more people get vaccinated.
About 41 percent of the state’s population has received at least one shot of a Covid-19 vaccine, and 25 percent have been fully vaccinated, according to data from the Centers for Disease Control and Prevention.
State officials said they would continue to monitor hospitalization levels. Under the governor’s public health order, the state could require counties to put in place additional restrictions if their resident hospitalizations threatened to exceed 85 percent of hospital capacity.
China’s CoronaVac vaccine provides robust protection against Covid-19, Chilean health authorities said Friday, citing the results of a study that monitored the health outcomes of millions of people who received the inoculant.
The two-dose vaccine, produced by the Beijing-based pharmaceutical company Sinovac Biotech, was 67 percent effective at preventing symptomatic Covid-19 cases and 80 percent effective at preventing death, according to Chile’s health ministry. The study also found the shot was 85 percent effective at preventing cases that required hospitalization.
The study in Chile, which has carried out one of the fastest Covid-19 vaccination campaigns in the world, provides a more positive assessment of the vaccine’s effectiveness than a clinical trial in Brazil that relied on medical professionals.
In January, scientists in Brazil said CoronaVac had an efficacy of just over 50 percent at preventing symptomatic cases, an underwhelming level compared to other Covid-19 vaccines. The study in Chile analyzed the health outcomes of more than 10 million people, including four million who received CoronaVac.
Officials in Chile called the results very promising for the country and the global effort to end the pandemic. CoronaVac is the most widely used vaccine in Latin America, where several countries, including Chile, have grappled with a rise of Covid-19 cases in recent months.
“This study is not only very important for Chile, but also for the world and the scientific community,” Chile’s deputy health secretary, Paula Daza, said in a statement. “It shows this vaccine is safe and that we must continue with the vaccination process.”
CoronaVac is being widely used in Brazil, where deaths have soared, and several other countries in the developing world. It is cheaper and easier to handle than the vaccines developed by Pfizer and Moderna.
“The effectiveness of the Sinovac vaccine reported by the Chilean Ministry of Health is encouraging news for low-income countries without access to Western vaccines,” said Denise Garrett, an epidemiologist at the Sabin Vaccine Institute in Washington, D.C.