Covid-19 Live News Tracker: Global Updates on Vaccines and Cases

The head of the Centers for Disease Control and Prevention, facing blowback over the agency’s new liberalized mask guidelines, offered a stark reassurance on Sunday: Only unvaccinated people are at risk if they take off their masks.

“If you are vaccinated, we are saying you are safe, you can take up your mask and you are not at risk of severe disease or hospitalization from Covid-19,” the C.D.C. director, Dr. Rochelle P. Walensky, said on “Fox News Sunday.” “If you are not vaccinated, you are not safe. Please go get vaccinated or continue to wear your mask.”

The guidance the C.D.C. issued on Thursday said that it was no longer necessary for fully vaccinated people to mask or maintain social distance in many settings. The change set off days of public confusion and drew objections from some local officials and labor unions, including the country’s largest union of registered nurses. A number of major U.S. retailers have already lifted mask requirements, essentially turning to an honor system that relies on unvaccinated people to keep their masks on in public.

In her round of the Sunday news shows on major networks, Dr. Walensky revealed a subtle but marked shift in her agency’s emphasis from community to individual protection. She acknowledged on Fox that “for 16 months, we’ve been telling people to be cautious, be careful, cases are going up” and made clear that the C.D.C.’s new bottom line is that individuals could make their own choices.

She also noted that communities where cases are high should consider keeping mask requirements, and that children who are not vaccinated — including everyone under 12 because they are not yet eligible for the shot — and people with compromised immune systems should keep their faces covered.

“This was not permission to shed masks for everybody everywhere,” Dr. Walensky said on NBC’s “Meet the Press,” but about “individual assessment of your risk.”

On a practical level, jurisdictions, including communities, schools and employers, look to the C.D.C., the nation’s top public health agency, for guidance as they set policy. The new recommendations create the possibility that there will be an increasing number of unmasked people in public venues with no certainty that they have the benefit of vaccination.

In her TV appearances, Dr. Walensky rejected the idea that pressure from a public and elected officials frustrated by more than a year of pandemic restrictions had prompted the new guidance, saying that it stemmed entirely from evolving science that shows the vaccines protect not just against getting severely ill from the coronavirus and its variants but also against spreading them.

The unvarnished message underscored the C.D.C.’s urgency to get the vaccine to more people. “Please go get vaccinated or continue to wear your mask,” Dr. Walensky said on Fox. She even dipped into details about how people can find where to get vaccinated, turning the discussion into a kind of public service message.

CHICAGO — The sudden loosening of federal health guidance on masks left Americans with options — and lots of questions. Would they leave the mask behind for a jog? What about the coffee shop? What about the neighbor’s house? The office?

The new rules have left Americans with a new calculation to make. And it isn’t just one calculation, but a maze of many. As people walked through their days, hour by hour, errand by errand, some wondered at every new doorway: Mask or no mask?

In interviews this weekend with dozens of residents from Los Angeles to Atlanta, people said they were mostly encouraged by the Centers for Disease Control and Prevention’s finding that masks were no longer needed for fully vaccinated people in most indoor and outdoor situations.

But the details, many said, were perplexing, and had stirred new questions about science, but also about trust, social norms and even politics. How can one be certain that people no longer wearing masks have actually gotten a vaccine? What will the neighbors think if you take yours off? (And what will they think if you don’t?) And what if, some asked, you just feel more comfortable in a mask?

Since the start of the pandemic, many conservatives bristled at being told they should wear face coverings, while liberals often took pride in masking, making mask mandates a constant source of debate and division. But now, as something close to the opposite of a mandate was arriving, that, too, was creating tumult within shops, neighborhoods and even families in the parts of the country where masks had remained common.

“At first, as a citizen, I was like, ‘Wow, these are so great. I haven’t been out to eat in a year,’” Angela Garbacz, 34, a pastry shop owner in Lincoln, Neb., said of the new recommendations, which have begun filtering out to states and cities and stores. “But as a private business owner, it has been like panic and, ‘What do we do?’ Are people just going to think they can come in without masks? Do I get rid of my mask requirement? It’s just so much uncertainty with the one thing that’s helped us feel safe in a really scary time.”

The Biden administration is struggling with a new and different wave of migration along the southwestern border: pandemic refugees.

These are people arriving in ever greater numbers from far-flung countries where the coronavirus has caused unimaginable levels of illness and death and decimated economies and livelihoods.

At the U.S.-Mexico border in recent months, agents have stopped people from more than 160 countries, and the geography coincides with the path of the virus’s worst devastation.

More than 12,500 Ecuadoreans were encountered in March, up from 3,568 in January. Nearly 4,000 Brazilians and more than 3,500 Venezuelans were intercepted, up from just 300 and 284, respectively, in January. The numbers in coming months are expected to be higher.

Some migrants from India reported taking buses in their hometowns to a big city, like Mumbai, where they boarded planes to Dubai and then connected through Moscow, Paris and Madrid, finally flying to Mexico City. From there, they embarked on the two-day bus ride to reach the Mexico-U.S. border.

Many of them are entering the United States through wide openings in the border wall near Yuma, Ariz. Border Patrol agents working in the Yuma sector said the number of migrants arriving there now dwarfs the surge of Central Americans two years ago that prompted some of the harsh immigration measures imposed by former President Donald J. Trump. They said they were struck by how far people had traveled.

Though no records are kept at the border on the reasons people have cited in choosing to move, interviews with many of those arriving, along with Border Patrol officials, shelter operators and immigration scholars, suggested that the job collapse brought about by the coronavirus — coupled with the Biden administration’s more welcoming policies — is driving much of the new surge.

Covid is ravaging Brazil, and, in a disturbing new wrinkle that experts are working to understand, it appears to be killing babies and small children at an unusually high rate.

Since the start of the pandemic, more than 434,000 people are known to have died of Covid in the country, and according to Brazil’s health ministry, 832 of them were children age 5 and under. The number is likely substantially larger, because a lack of widespread testing means many cases go undiagnosed.

Comparable data is scarce because countries track the impact of the virus differently, but in the United States, which has a far larger population than Brazil, and a higher Covid death toll, 139 children 4 and under have died.

Dr. Fátima Marinho, an epidemiologist at the University of São Paulo, is leading a study tallying the death toll among children based on both suspected and confirmed cases. She estimates that more than 2,200 children under 5 have died since the start of the pandemic, including more than 1,600 babies less than a year old.

“It’s a number that’s absurdly high,” Dr. Marinho said. “We haven’t seen this anywhere else in the world.”

The P.1 variant that emerged in Brazil appears to be one factor. “We can already affirm that the P.1 variant is much more severe in pregnant women,” said Dr. Ribas Freitas. “And, oftentimes, if the pregnant woman has the virus, the baby might not survive or they might both die.”

Lack of timely and adequate access to health care for children once they fall ill is likely another factor, experts said.

Israel’s airstrikes and shelling of Gaza have stopped all Covid-19 vaccinations and testing in the Palestinian enclave and raise the risk of super-spreading as civilians cram into shelters for safety, United Nations officials said.

In an interview over Zoom on Friday as the sound of Israeli explosions shook their headquarters, the leaders of the U.N. Palestinian relief agency’s operations in Gaza and the head of the World Health Organization’s Gaza sub-office said they feared that a severe worsening of Covid-19 infections would be a side-effect of the death and destruction from the latest surge in hostilities.

The number of people in Gaza sickened from Covid-19 had been “just leveling off, and then this hit,” said the U.N. agency official, Matthias Schmale. “It is a grim situation.”

He said that unvaccinated Gazans were crowding into the schools run by his agency, known as the United Nations Relief and Works Agency, because the Israelis do not intentionally target those buildings — in effect making them bomb shelters. Now, Mr. Schmale said, those schools “could turn into mass spreaders.”

Last month, severe and critical cases of Covid hit record highs in Gaza, which health experts attributed to the proliferation of the highly transmissible coronavirus variant first identified in Britain. In early May, Doctors Without Borders reported that the territory’s infections were topping 1,000 a day.

Sacha Bootsma, the W.H.O. official, said that before the vaccinations had stopped, 38,000 people in Gaza had received at least one dose of vaccine. That is less than 2 percent of the population of two million. Russia’s Sputnik vaccine and the Pfizer-BioNTech vaccine were given at three Gaza hospitals, and AstraZeneca’s vaccine was being administered at smaller health centers.

But now, Ms. Bootsma said, “People are not daring to visit health facilities. We are fearing this will have a major negative impact.”

By contrast, more than 60 percent of the Israeli population has received at least one dose of either the Pfizer-BioNTech or Moderna vaccines, and more than 55 percent are fully vaccinated, according to the Our World in Data project at the University of Oxford. However, the pace of vaccinations has slowed tremendously in recent months.

Under Covax, the international collaboration to provide vaccines to poor parts of the world, Gaza is supposed to receive enough vaccine to protect 20 percent of its population, the officials said.

But the deliveries, flown to Israel’s Ben Gurion Airport and then sent by land across the border to Gaza, have been indefinitely suspended because air service into Israel has been curtailed by the hostilities. Assuming they resume soon, it still remains unclear when Gaza’s border crossings might reopen.

“The biggest problem now is the borders are closed,” Mr. Schmale said. “Even if there were a delivery, we would not be able to receive any supplies.”

GLOBAL ROUNDUP

A severe cyclone expected to make landfall in India’s northwest state of Gujarat on Sunday evening forced officials to suspend coronavirus vaccinations in parts of the Covid-ravaged country, including the city of Mumbai, at least until Tuesday.

Heavy rainfall and winds from the storm, Cyclone Tauktae, have already killed at least six people and prompted tens of thousands more to evacuate their homes. But the storm’s effects could be far graver, coming as India is grappling with a terrible wave of illness and death from the coronavirus that has left hospitals filled to capacity and sick people struggling to get care.

More than 266,200 people in India have died from the virus, but experts say that is almost certainly an undercount.

Officials in Gujarat said that arrangements had been made for patients at Covid centers to continue to receive treatment. Hospitals were sealing windows and doors, and more than 170 mobile intensive care unit vans were being deployed to provide emergency care, according to local media.

Dozens of disaster management teams have been deployed in several states, along with army, navy and coast guard units, the government said, adding in a statement on Sunday that it was taking steps to ensure “zero loss of life.”

In other news around the world:

• On Monday, Portugal will begin allowing visitors from Britain again. The reopening comes after the British government agreed to include Portugal on a list of countries where travelers will be allowed to visit and not have to quarantine upon returning. The reopening could be a major boon for Portugal’s summer tourist season, as the British form the largest contingent of foreign visitors to the country. Thousands of English soccer fans are already set to travel to Portugal to attend the Champions League final in Porto on May 29.

• Days after ending its divisive ban on allowing citizens to return from India, Australia carried out its first repatriation flight from that country, with the plane departing from New Delhi and arriving in Darwin, in Australia’s Northern Territory, on Saturday. The flight had been scheduled to carry 150 passengers, but just 80 people were on it, after 70 people were barred from travel because they or their close contacts had tested positive for Covid-19, according to the Australian government. The new arrivals in Australia now face two weeks of quarantine in a converted mining camp outside Darwin.

• Turkey will start to ease strict lockdown measures on Monday, shifting to a less restrictive program that still mandates curfews on weeknights and weekends, The Associated Press reported. Shopping malls will be allowed to reopen, and while some businesses like gyms and cafes have to stay closed, restaurants will be permitted to offer takeout and delivery services. Turkey reported an average of 12,960 new daily cases on Saturday, down from a peak of about 60,200 in late April, according to the Our World in Data project at the University of Oxford.

Only a trickle of people had visited her community vaccination site in Philadelphia seeking a first coronavirus shot last Monday when Dr. Ala Stanford, a local pediatric surgeon, seized on an unexpected opening.

Across the street, a funeral home was holding services, including one for a victim of Covid-19. She mocked up new fliers, then delivered them to the funeral home. By the afternoon, several workers and guests had crossed the street to get inoculated.

The scene underscored what the Biden administration has called a new phase of its vaccination campaign.

The federal government has set up mass vaccination sites, sent doses to pharmacies and clinics serving lower-income Americans, and, on Friday, enticed the unvaccinated with the prospect of finally being able to shed their masks.

But with the ranks of the willing and able dwindling, the campaign has in many places already morphed into a door-to-door and person-by-person effort.

The Black Doctors Covid-19 Consortium, which Dr. Stanford leads, is one of about 11,000 members of what the Department of Health and Human Services is calling its Covid-19 community corps: volunteers, corporations, advocacy groups and local organizations working to vaccinate Americans often left behind by the nation’s health care system.

Begun last month, the network operates on the belief that once the people most eager for a shot were done, those left unvaccinated will prefer to get their shots by or around people they know.

A coronavirus second wave has devastated India’s medical system and undermined confidence in the ability of Prime Minister Narendra Modi’s government to treat its people and quell the disease. There are widely believed to be far more deaths than the thousands reported each day. Hospitals are full. Drugs, vaccines, oxygen and other supplies are running out.

Pandemic profiteers are filling the gap. Medicine, oxygen and other supplies are brokered online or in hushed phone calls. In many cases, the sellers prey on the desperation and grief of families.

Sometimes the goods are fraudulent, and some are potentially harmful. Last week, police officers in the state of Uttar Pradesh accused one group of stealing used funeral shrouds from bodies and selling them as new. The day before, officers in the same state discovered more than 100 vials of fake remdesivir, an antiviral drug that many doctors in India are prescribing despite questions about its effectiveness.

Over the past month, the New Delhi police have arrested more than 210 people on allegations of cheating, hoarding, criminal conspiracy or fraud in connection with Covid-related scams. Similarly, the police in Uttar Pradesh have arrested 160 people.

The nation’s largest union of registered nurses condemned the Centers for Disease Control and Prevention on Saturday for lifting mask recommendations for vaccinated people and called on the agency to “do the right thing” and revise its guidance.

Bonnie Castillo, a registered nurse and executive director of the union, National Nurses United, said the most recent guidance, which was issued on Thursday and rolled back mask recommendations and other precautions for those who are fully vaccinated, “is not based on science.” Ms. Castillo said the new guidance would jeopardize the health of frontline workers and the general public and would disproportionately harm people of color.

Many major U.S. retailers have dropped mask requirements since Thursday, effectively moving to an honor system in which they trust that only vaccinated people will bare their faces.

“This is a huge blow to our efforts at confronting this virus and the pandemic,” said Ms. Castillo, whose union represents 170,000 nurses nationwide. “The mask is another lifesaving layer of protection for workers,” she said.

Although vaccination is vitally important to stopping the virus’s spread, she noted that millions of Americans still had not been vaccinated. Less than half of the population has had a single dose of vaccine, and less than 40 percent are fully vaccinated.

The union also criticized the C.D.C. for other actions, including its decision to stop monitoring breakthrough infections among vaccinated individuals and to investigate such cases only if they result in a hospitalization or death. The agency announced that, as of May 1, it would no longer track or investigate all infections among vaccinated people so that it could “maximize the quality of the data collected on cases of greatest clinical and public health importance.”

The nurses said that meant the C.D.C. would not gather the data necessary to understand whether vaccines prevent mild and asymptomatic infections, how long vaccine protection lasts and what role variants play in breakthrough infections.

The union also called on the agency, which recently recognized that the virus could be transmitted through aerosolized particles, to update its guidance about ventilation and respiratory protection accordingly. The union also called on the Occupational Safety and Health Administration to immediately issue emergency temporary standards on infectious diseases to protect people in the workplace.

The C.D.C. did not immediately respond to the criticisms. Introducing the new recommendations on Thursday, Dr. Rochelle P. Walensky, the C.D.C. director, cited two recent scientific findings as significant factors: Few vaccinated people become infected with the virus, and transmission seems rarer still; and the vaccines appear to be effective against all known variants of the coronavirus.

The union noted that more than 35,000 new cases of coronavirus were being reported each day and that more than 600 people were dying each day. “Now is not the time to relax protective measures, and we are outraged that the C.D.C. has done just that while we are still in the midst of the deadliest pandemic in a century,” Ms. Castillo said.

The Centers for Disease Control and Prevention on Saturday clarified coronavirus advice for American schools, recommending the continued, universal use of masks and physical distancing, after the agency’s sudden announcement that vaccinated Americans could forego masks indoors.

All schools teaching students from kindergarten through grade 12 should continue to implement proper mask-wearing through the end of the 2020-2021 school year, the C.D.C. said. The agency also kept in place its suggestions to observe physical distancing and to test for coronavirus infections. “Our school guidance to complete the school year will not change,” the C.D.C. director, Dr. Rochelle P. Walensky, said on “Fox News Sunday,” adding that the agency would work over the summer to update its school guidance for the fall.

“We need to update our school guidance, child care guidance, travel guidance — we have a lot of work that we need to do, ” Dr. Walensky said. “We are actively working on that now.”

About 122 million people had been fully vaccinated against Covid-19 in the U.S. as of Saturday, but the average number of vaccinations per day has dropped since its peak in April, according to C.D.C. data. News of the C.D.C.’s sweeping change to mask rules that were introduced a year ago came suddenly last week, prompting elation among many Americans but also some confusion over how to respond to the new guidance.

The C.D.C.’s advice for schools attempts to clear up some of the confusion. On Monday, the Food and Drug Administration authorized the use of the Pfizer-BioNTech Covid-19 vaccine for 12- to 15-year-olds in the United States. But some parents are still hesitant about the vaccine. And no vaccines have been authorized yet for children under 12.

Two recent scientific findings were significant factors in the C.D.C.’s decision to change its advice on mask-wearing for vaccinated people: few of those vaccinated become infected with the virus and transmission seems rarer still, and the vaccines widely used in the United States appear to be effective against all known variants of the coronavirus.