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An F.D.A. panel recommends Pfizer boosters for those over 65 or at high risk of severe Covid.

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The Centers for Disease Control and Prevention released data on Friday indicating that the level of protection against Covid hospitalizations afforded by the Pfizer-BioNTech vaccine dropped significantly in the four months after full inoculation.

The data was released hours before a scientific advisory committee to the Food and Drug Administration recommended authorizing booster shots for recipients of the Pfizer coronavirus vaccine who are 65 or older or are at high risk of severe Covid-19, at least six months after the second shot.

The new study found that from two weeks after recipients got their second dose — a point at which they are normally considered fully vaccinated — to four months later, the Pfizer vaccine was 91 percent effective in preventing hospitalization. Beyond 120 days, though, its effectiveness fell to 77 percent.

The Moderna vaccine showed no comparable decrease in protection over the same time frame: It was 92 percent effective against hospitalizations four months after recipients’ vaccination, a level virtually identical to its 93 percent effectiveness before then.

The study said that not enough participants had received the one-shot Johnson & Johnson vaccine to compare its performance. Overall, though, the Johnson & Johnson shot has been 71 percent effective in preventing hospitalizations.

The C.D.C. study released on Friday supported some others that suggested the Pfizer vaccine may offer less protection from hospitalization over time. But the available data is far from unanimous.

Other studies have shown that Pfizer’s effectiveness against hospitalization has remained above 90 percent, despite the spread of the Delta variant and the lengthening time since people received their second shots. Pfizer has said that data from Israel suggest a falling effectiveness against severe disease, though it appears that Israel and the United States define “severe disease” differently.

The latest C.D.C. study was based on an analysis of roughly 3,700 adults hospitalized across the United States from March to August.

People with compromised immune systems, who typically don’t respond as well to vaccines, were excluded from the study. Nevertheless, the vaccinated patients tended to be older people — the Pfizer cohort had a median age of 68 — and it was unclear whether vaccine effectiveness had changed much in younger age groups. Previous studies have shown lower levels of protection in older people.

The authors of the study said that the gap in the performance of the Moderna and Pfizer vaccines could stem from higher doses of mRNA in the Moderna shots or the four-week space between doses of the Moderna vaccine. (Pfizer vaccines were given three weeks apart.) It’s also possible, they said, that other, unnoticed differences in the study participants receiving either shot could have also influenced the results.




F.D.A. Panel Greenlights Pfizer Boosters for High Risk Individuals

An advisory committee to the Food and Drug Administration recommended authorizing booster shots for recipients of the Pfizer-BioNTech Covid-19 vaccine who are 65 or older or are at high risk of severe illness.

“This is the voting question No. 2 that we will ask the committee to consider: Based on the totality of scientific evidence available, including the safety and effectiveness data from Clinical Trial C4591001, do the known and potential benefits outweigh the known and potential risks of a Pfizer-BioNTech Covid-19 vaccine booster dose administered at least six months after completion of the primary series for use in individual 65 years of age and older, and individual at high risk of severe Covid-19?” “We do have a unanimous 18 out of 18 who voted ‘yes’ for this question.”

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An advisory committee to the Food and Drug Administration recommended authorizing booster shots for recipients of the Pfizer-BioNTech Covid-19 vaccine who are 65 or older or are at high risk of severe illness.CreditCredit…Saul Martinez for The New York Times

A key advisory panel to the Food and Drug Administration overwhelmingly rejected recommending Pfizer booster shots for most recipients of the company’s coronavirus vaccine, instead endorsing them only for people who are 65 or older or at high risk of severe Covid-19.

The vote — the first on boosters in the United States — was a blow to the Biden administration’s strategy to make extra shots available to most fully vaccinated adults in the United States eight months after they received a second dose. The broader rollout was to start next week.

Committee members appeared dismissive of the argument that the general population needed booster shots, saying the data from Pfizer and elsewhere still seemed to show two shots protected against severe disease or hospitalization and did not prove a third shot would stem the spread of infection. Some also criticized a lack of data that an additional injection would be safe for younger people.

“It’s unclear that everyone needs to be boosted, other than a subset of the population that clearly would be at high risk for serious disease,” said Dr. Michael G. Kurilla, a committee member and official at the National Institutes of Health.

But the panel’s final recommendation left some room for the White House to argue that the core of its booster strategy remains intact. Depending on how “at high risk” is defined, tens of millions of Americans could conceivably wind up eligible for additional shots of the Pfizer vaccine.

The committee of largely outside experts voted 16 to 2 against a Pfizer booster for people 16 and older after a tense daylong public discussion that put divisions within the agency and the administration on public display. Officials from the Centers for Disease Control and Prevention and the National Institutes of Health joined infectious disease experts and doctors in voting against additional shots for such a broad swatch of the population.

Dr. Paul Offit, a committee member and the director of the Vaccine Education Center at Children’s Hospital of Philadelphia, questioned whether extra shots would do much at all to change the arc of the pandemic. “We all agree that if we really want to impact this pandemic, we need to vaccinate the unvaccinated,” he said.

But the panel unanimously embraced a fallback position to limit additional shots to the elderly and others at high risk of severe Covid illness. Then, after an informal poll pushed by a senior F.D.A. official, committee members specified that health care workers, emergency responders and others whose jobs put them at special risk should also be eligible for the booster shots. The official — Dr. Peter Marks, who oversees the F.D.A.’s vaccine division — said the at-risk group would also include teachers.

Biden aides noted that under the White House’s plan to offer booster shots eight months after the second injections, that same group would be first in line because they were vaccinated earliest.

Pfizer praised the decision, with Kathrin U. Jansen, senior vice president and head of vaccine research and development, saying it underscored “our belief that boosters can be a critical tool in the ongoing effort to control the spread of this virus.”

The F.D.A. has the final word on vaccine approvals, and while it is not obliged to follow the committee’s recommendations, it typically does. The agency will likely issue a decision by early next week.

An advisory committee of the C.D.C. is scheduled to meet Wednesday and Thursday to discuss booster shots before that agency, which sets vaccine policy, issues recommendations on who should get them.

Critics of the administration’s booster strategy as overly broad or premature said the advisory committee acted as a necessary check Friday.

The meeting “put the F.D.A. back in the driver’s seat,” said Dr. Luciana Borio, a former acting chief scientist at the agency. The expert panel, she said, “was allowed to maintain its scientific independence. It understood there were significant limitations with the data presented and that the F.D.A. needs to review the data carefully before making a decision.”

Apoorva Mandavilli and Sheryl Gay Stolberg contributed reporting.

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Advisers to the Food and Drug Administration on Friday questioned a key assertion by researchers in Israel and by the drug company Pfizer: that its coronavirus vaccine is waning in protection not just against infection, but against severe illness and hospitalization.

The advisers met to evaluate Pfizer’s application for approval of booster vaccine doses for all Americans over age 16. Among the details that surfaced during the lively debate: Israel and the United States define severe illness differently.

In Israel, anyone with an accelerated respiratory rate and an oxygen level of below 94 percent is severely ill. By contrast, the Centers for Disease Control and Prevention considers people who are sick enough to be hospitalized as having severe disease, Dr. Sara Oliver, a C.D.C. scientist, said at the advisory committee meeting.

The discrepancy might help explain why the two countries have reported vastly different outcomes in people who are fully immunized.

Israeli researchers said they have seen large numbers of hospitalized patients who had received two doses months earlier. But in the United States, the C.D.C. has reported that vaccinated patients make up just 2 percent of people hospitalized for Covid-19.

It is just one of many scientific discrepancies that came to light this week.

On Monday, in the journal The Lancet, an international team of scientists analyzed dozens of studies and concluded that boosters are not yet needed by the general population, and that the world would be better served by using vaccine doses to protect the billions of people who remain unvaccinated.

On Wednesday, scientists at the F.D.A. posted an assessment online hinting that they, too, are unconvinced that there’s enough evidence that boosters are needed.

“Overall, data indicate that currently U.S.-licensed or authorized Covid-19 vaccines still afford protection against severe Covid-19 disease and death in the United States,” according to their executive summary.

But some F.D.A. leaders have publicly endorsed booster shots. “The need for an additional dose at six months to provide longer-term protection should not come as a surprise, as it’s likely necessary for the generation of a mature for immune response,” Dr. Peter Marks, one of the agency’s top officials, said in the meeting on Friday.

Alarmed by the rise in cases, Israeli officials have offered third doses of the vaccine to everyone older than 12. Researchers from Israel published early results from that rollout on Wednesday in the New England Journal of Medicine — but few outside scientists found the study convincing.

The team collected data on the effects of booster shots from the health records of more than 1.1 million people over age 60. At least 12 days after the booster, rates of infection were elevenfold lower — and rates of severe disease nearly twentyfold lower — in those who received a booster compared with those who had received only two doses, the researchers found.

The results are unsurprising, experts said, and do not indicate long-term benefit.

Credit…Amr Alfiky/The New York Times

“We have known for some time that the vaccines elicit less robust immune responses in the elderly,” said Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center and a former adviser to the Biden administration. “Recommending additional doses of vaccine for the elderly isn’t controversial.”

Vaccination remains powerfully protective against severe illness and hospitalization in the vast majority of people in all of the studies published so far, experts said. But the vaccines do seem less potent against infections in people of all ages, particularly those exposed to the highly contagious Delta variant.

The cumulative data so far suggest that only older adults will need boosters, a view underscored by the F.D.A.’s advisory committee, which voted on Friday to endorse boosters only for Americans aged 65 and older, and those who are at risk for severe illness.

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The Biden administration is negotiating with Pfizer to buy another 500 million doses of Covid-19 vaccine to donate overseas, which would bring the total number of planned donations to 1.15 billion doses — about a tenth of the world’s need — according to two people familiar with the plan. It was not immediately clear over what time period the donation would be.

The deal is not yet final, but the talks come just as the White House announced Mr. Biden will host a global Covid summit that on the sidelines of the United Nations General Assembly meeting next week. The president will use the summit to convince other nations to set aside domestic demands and instead focus on getting vaccine doses to poor countries dependent on donated shots.

White House officials said that Mr. Biden’s message to other nations is that the United States cannot and should not do it alone, and that all nations should honor exiting commitments.

The talks with Pfizer, which were reported without specifics earlier in The Washington Post, also come as Mr. Biden is under fire for proposing booster shots for already vaccinated Americans while citizens of poor nations have not even had their first doses. A scientific advisory committee to the Food and Drug Administration on Friday recommended booster shots for recipients of the Pfizer-BioNTech coronavirus vaccine who are 65 or older or are at high risk of severe Covid-19, at least six months after the second shot. The move came shortly after the panel overwhelmingly recommended against approving a Pfizer booster for people 16 and older.

Jeff Zients, Mr. Biden’s coronavirus response coordinator, declined to offer specifics on the talks, saying only that how to help the 100 countries that are most in need would be “a big topic of conversation” at the U.N. gathering.

The World Health Organization has asked world leaders to refrain from rolling out boosters at least until the end of the year, with the goal of immunizing 40 percent of the global population first. Its experts, and others, have said a much more aggressive — and comprehensive — approach to fighting the global pandemic is needed.

“A piecemeal approach favors those who can most easily pay,” Dr. Kate O’Brien, the W.H.O.’s top vaccines expert, told reporters earlier this week. Without naming the United States, she noted that some countries are “moving forward with booster programs for which we do not see evidence that would support a need for broad booster programs in the general population. And at the same time, others haven’t even started vaccinating health workers or high risk groups sufficiently.”

The summit, which Mr. Biden plans to convene on Wednesday, will be the largest gathering of heads of state dedicated to addressing the coronavirus crisis. Previous gatherings have included much smaller groups of leaders, like those from the Group of 7 nations.

White House officials said that Mr. Biden aimed to inject a fresh sense of urgency in the fight against the pandemic, as well as to “create a bigger tent” of people and groups committed to ending the pandemic. Pharmaceutical makers, philanthropists and nongovernmental organizations are being invited to participate.

The officials said that Mr. Biden wants to forge consensus around a broad framework for action, including specific targets for vaccination. The officials offered few specifics, saying that the precise goals were still under discussion.

However, the White House sent a draft document to summit invitees earlier this week that called for 70 percent of the world’s population to be vaccinated by the time the U.N. gathers again in September of next year.

Experts have estimated that 11 billion doses are necessary to achieve broad global immunity to the coronavirus. The United States has already committed to sending more than 600 million doses abroad, and is working to scale up manufacturing in this country and overseas, particularly in India.

But global health advocates say donating doses is not enough. They want Mr. Biden to work to create manufacturing hubs in many other countries and to press vaccine makers to share their technology as part of a far-reaching plan similar to the one former President George W. Bush created to address the global AIDS epidemic.

The White House officials who discussed Mr. Biden’s summit plan insisted the United States can do both. In an interview earlier this week, Dr. Anthony S. Fauci, Mr. Biden’s top adviser for the coronavirus — and a driving force behind Mr. Bush’s Emergency Plan for AIDS Relief — said the administration was committed to doing more.

“We’re trying to figure out what is the best way to get a really fully impactful program going,” Dr. Fauci said, noting that building manufacturing plants overseas might be a reasonable step to prepare for any future pandemics, but could not happen quickly enough to end this one. “We want to do more, but we’re trying to figure out what the proper and best approach is.”

Reaching specific global vaccination targets has so far proven difficult. Covax, the U.N.-backed vaccine distribution program, announced this month that it would not be able to meet its forecast for doses available in 2021. So far, only 20 percent of people in poor and middle-income nations have received at least one dose of a Covid vaccine.




England to Ease International Travel Restrictions

Britain announced it would relax and simplify rules on international travel in and out of England starting on Oct. 4, citing the success of its vaccination rollout.

Today, we’re announcing a new, simpler, easier system, which will decrease the burden on people traveling and stay in place at least till the new year. It means you won’t have to take a pre-departure test. The Day 2 P.C.R. test will be scrapped in favor of a lateral flow, and all of this is only available because so many people have been vaccinated. Nine out of 10 adults in this country are there, and its enabled us to scrap the traffic light system and make travel easier for people once again while still maintaining that protection for everybody’s health. If you’ve not been vaccinated and I don’t mean for a medical reason, but just because you choose not to be vaccinated, then, of course, you would have to carry on taking the additional test, which does involve the extra money. Most people will say nine out of 10 adults have been vaccinated in this country, so this simply doesn’t apply to most people. And actually, the other thing I’m announcing today is there’s going to be over 50 countries where we’re going to recognize their vaccine programs in addition to the E.U. and the United States. So, many other countries now will come into that regime where people can come here and they won’t need to take P.C.R. tests and self-isolate.

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Britain announced it would relax and simplify rules on international travel in and out of England starting on Oct. 4, citing the success of its vaccination rollout.CreditCredit…Andy Rain/EPA, via Shutterstock

Citing the success of Britain’s vaccine rollout, government authorities announced on Friday that coronavirus restrictions on international travel in and out of England would be eased beginning at 4 a.m. local time on Oct. 4.

The current three-tier, traffic-light-inspired system, which was introduced in May, caused confusion among Britons and the travel industry. The system going into place next month replaces that with a single “red” list of countries and territories that present the highest coronavirus risk, and simplified travel measures for arrivals from the rest of the world.

The changes were announced in a statement from Britain’s departments of Transport and Health and Social Care; the health secretary, Sajid Javid; and the transportation secretary, Grant Shapps. Mr. Shapps said it represented a simpler, more straightforward system, “one with less testing and lower costs, allowing more people to travel, see loved ones or conduct business around the world while providing a boost for the travel industry.”

The statement announced other changes as well: Starting on the same day, fully vaccinated passengers will no longer be required to take a coronavirus test before arriving in England from a country that is not on the red list, and that the test they must take on the second day after their return can be a rapid test, which is less expensive than the more accurate PCR test.

However, anyone testing positive will be required to isolate and receive negative results from a PCR test, which will be free to the traveler. The samples will be “genomically sequenced to help identify new variants,” the government’s statement said.

A negative test ahead of arrival will still be required for unvaccinated passengers, and they will also still be required to have PCR tests two and eight days later. Unvaccinated people arriving in England from red list countries will have to quarantine in a government-approved hotel for a mandatory 10 nights at their own cost.

And next week, eight countries will be removed from England’s red list: Turkey, Pakistan, the Maldives, Egypt, Sri Lanka, Oman, Bangladesh and Kenya.

Sixty-six percent of the population of the United Kingdom is fully vaccinated, and an additional 6 percent have received a first dose. But average daily deaths have risen 24 percent over the last two weeks.

And the pandemic is playing out differently across the four U.K. nations — England, Scotland, Wales and Northern Ireland — which operate independently on pandemic travel restrictions, as in many other areas of governance.

On Friday, the BBC reported that the government of Wales, where average daily cases are up 19 percent over the last two weeks, said it would follow England’s lead in adjusting its red list, and that it would “carefully consider” the proposed changes on testing.

Scotland, where average daily cases have fallen by 30 percent over the last two weeks, said that it was also easing travel restrictions, but would maintain the requirements for Day 2 and Day 8 PCR tests for vaccinated arrivals to minimize “the risk of importing variants of concern.”

The government of Northern Ireland website did not offer new guidance on its travel restrictions; cases are flat there. England’s cases are dropping off from a recent spike.

So far, 73 percent of people in Britain have received a single dose of a coronavirus vaccine, while 66 percent have received two doses, according to data collated by The New York Times.

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A scientific advisory committee to the Food and Drug Administration on Friday voted to recommend authorizing booster shots for recipients of the Pfizer-BioNTech coronavirus vaccine who are 65 or older or are at high risk of severe Covid-19, at least six months after the second shot.

The move came shortly after the panel overwhelmingly recommended against approving a Pfizer booster for people 16 and older.

There is no clear timeline for when the F.D.A. might put the possibility of booster shots for the two other vaccines available for use in the United States through the same process.

Covid vaccines made by Moderna and Johnson & Johnson are the other shots the F.D.A. has authorized for emergency use for those 18 and older. (Pfizer’s vaccine is the only one that has been fully approved for use in people 16 and older; it has emergency authorization for 12- to 15-year-olds.)

The question of whether booster shots are necessary has been the subject of intense debate and multiple studies since August, when President Biden announced that he planned to make booster shots available to adult recipients of the Pfizer-BioNTech and Moderna vaccines in September.

Dr. Janet Woodcock, the acting commissioner of the F.D.A., had hoped that booster shots could be offered this month not only for Pfizer and Moderna recipients, but for recipients of Johnson & Johnson’s one-dose vaccine as well, according to people familiar with the deliberations. But the administration had to limit its plan to Pfizer recipients, officials said, because neither Moderna nor Johnson & Johnson delivered the necessary data to the F.D.A. in time.

Moderna submitted an application for its booster dose to the F.D.A. earlier this month. A spokeswoman for the company said in an email on Thursday that she did not have an update on when the F.D.A. might act on its application.

Johnson & Johnson has not yet applied for booster clearance. A Johnson & Johnson spokesman said in an email on Thursday that the company planned to file for federal authorization for the vaccine by the end of the year, but did not provide a timeline.

Sharon LaFraniere and Noah Weiland contributed reporting.

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Young students who recently endured a year of pandemic lockdowns may have suffered deteriorating eyesight, according to a study published Thursday in Jama Ophthalmology.

The study was conducted by the Sun Yat-sen University School of Public Health, based on data from annual eye exams given to more than 2,000 students in a dozen primary schools in Guangzhou, China, from 2018 to 2020.

About 13 percent of second-grade students who had eye exams in 2018 developed nearsightedness by 2019, according to the study. By comparison, more than 20 percent of those who had eye exams in 2019 became nearsighted by 2020, a statistically significant difference. Initial tests of both groups showed that about 7 percent of the students were nearsighted.

The effects on the eyesight of students ages 9 and older appeared to be negligible, the researchers said. The findings suggested that younger children were more susceptible to environmental effects on their vision.

The study did not explore the hours children spent in front of computer screens as part of remote learning, or the time spent reading books — avid young readers may develop nearsightedness as well — so it is not possible to draw conclusions about the effects of screen time on their eyesight.

But Dr. Carlos Emmanoel Chua, president of the Philippine Society of Pediatric Ophthalmology and Strabismus, said that studies in Hong Kong, Singapore and China had also concluded that the pandemic has had a negative impact on children’s vision for various reasons.

“Whether it’s due to being stuck indoors, doing more indoor activities and online schooling, or not being able to see their doctor for their annual appointments to check for progression, more students have developed nearsightedness during the pandemic than before,” he said.

A study of children in Australia and Singapore in 2018 found that outdoor activities, even for just a few hours a day, helped reduce the risk of nearsightedness. This was one of the findings that Dr. Chua said prompted pediatric ophthalmologists in the Philippines to start a pre-Covid campaign to encourage children to play outside.

The Philippines is one of only a few countries where schools still have not reopened and children continue to learn remotely. Dr. Chua said that during the pandemic his group had increased efforts to push for more frequent outdoor play and breaks from screens.

“A little bit of extra outdoor activity will help slow down the progression of myopia,” he said. “You have to take your breaks.”

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New coronavirus cases and Covid hospitalizations across the United States have started to show signs of decline, although they remain far higher than they were earlier in the summer, and the number of new deaths is still increasing.

As the Delta variant has ripped through unvaccinated communities, reports of new deaths have reached an average of more than 1,900 a day, up nearly 30 percent in the past two weeks, according to a New York Times database. Approximately one in every 500 Americans has died from the disease.

The pace of vaccinations remains relatively sluggish, with 64 percent of eligible people in the United States fully vaccinated, according to federal data. (No shots have been federally authorized for children younger than 12.)

Vaccination remains powerfully protective against severe illness and hospitalization because of Covid-19 in the vast majority of people in all of the studies published so far, experts say. Health officials say that most of the patients who are being hospitalized and dying are not vaccinated, while areas with higher rates of vaccination have generally fared better. Over the summer, masks were recommended indoors for everyone, regardless of vaccination status, in virus hot spots and in schools across the country.

Some states have seen their hospital intensive-care wards become overwhelmed with Covid-19 patients, and have called in National Guard help or set up overflow units in parking lots. Idaho officials activated on Thursday “crisis standards of care,” meaning that hospitals can ration treatment if necessary.

Across the country, one in four U.S. hospitals reported that more than 95 percent of intensive care beds were occupied as of the week ending Sept. 9, up from one in five in August. Experts say that hospitals could struggle to maintain standards of care for the sickest patients when all or nearly all I.C.U. beds are occupied.

Conditions are beginning to improve in some hard-hit regions. Southern states like Florida, Mississippi and Georgia are seeing some declines in new cases and hospitalizations.

But new outbreaks are spreading in the Mountain West and Upper Midwest. West Virginia, where a smaller percentage of residents are vaccinated than in any other state, now leads the country in new cases per capita.

The Delta variant has caused record numbers of pediatric infections and hospitalizations, although children are far less likely than adults to die or become very ill from the virus. Some schools that reopened for in-person instruction have closed temporarily because of outbreaks and staff shortages.

For those who are vaccinated, a scientific advisory committee to the Food and Drug Administration on Friday recommended booster shots for recipients of the Pfizer-BioNTech coronavirus vaccine who are 65 or older or are at high risk of severe Covid-19, at least six months after the second shot.

The move came shortly after the panel overwhelmingly recommended against approving a Pfizer booster for people 16 and older.

Asked on Tuesday on the MSNBC program “Morning Joe” whether he thought the struggle against the coronavirus would become a “forever war,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said, “I don’t believe it needs to be.” But he said success in reining in the virus will depend on as many people as possible getting vaccinated.

To those who resist the shots, Dr. Fauci said: “You’re not in a vacuum, you’re part of society. And do you want to be part of the component that propagates the virus and propagates the outbreak, or do you want to be part of the solution?”

Mitch Smith and Sarah Cahalan contributed reporting.

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India’s far-reaching effort to vaccinate its vast population against Covid-19 hit another milestone on Friday: Its health ministry said that a record 25 million shots had been administered over the course of the day, a special push to mark the birthday of Prime Minister Narendra Modi and celebrate his 20 years in public office.

That is more than two and a half times its previous daily record — 9.3 million shots, reached on Sept. 2 — and more than seven times the level reported three months ago, according to the Our World in Data Project at Oxford University.

Leaders of India’s governing Bharatiya Janata Party said that states under its control had long aimed to maximize a vaccination push as a birthday gift for Mr. Modi, who turned 71 on Friday.

“Good health is indeed wealth and a great way to celebrate PM @NarendraModi ji’s birthday,” India’s federal health minister, Mansukh Mandaviya, wrote on Twitter. Videos of the prime minister were circulated showing him distributing sweets to health workers.

India has administered over 793 million vaccine shots through a drive that had major setbacks in its early stages — although inoculating a population of 1.4 billion people, spread from the Himalayas to the coasts, was always going to be a challenge. The drive has gained considerable momentum in recent weeks.

The country is now recording over 30,000 new Covid-19 cases a day. With a total of more than 33 million total cases during the pandemic, its reported caseload is second only to that of the United States, and India was the third country to top 400,000 deaths. Scientists widely believe that the official figures vastly undercount the toll.

On Friday, the eastern state of Bihar, which is home to an estimated 127 million people and is one of the poorest regions in the country, gave 2.9 million shots, more than any other state, according to a government database.

In Mumbai, India’s financial capital, civic authorities organized a special vaccination drive for women, and many lined up for shots.

Health ministry officials say they plan to administer over a billion shots by mid-October. China, the only other country with a population of more than a billion people, has already far surpassed that number, reporting 2.16 billion shots, according to Our World in Data.

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The Australian state of New South Wales will allow some returning international travelers to quarantine at home starting at the end of the month, possibly signaling the beginning of the end for the country’s strict hotel quarantine system.

The pilot program will allow 175 fully vaccinated people to isolate in their homes for seven days rather than spend two weeks in a government-appointed facility, Stuart Ayres, a New South Wales government official, announced on Friday. The police will employ location-based tracking and facial-recognition technology to monitor new arrivals’ movements, he added. Similar technology has been used in Western Australia since November.

The program will help the country plan next steps toward ending the current system, Mr. Ayres said at a news conference: “We’ve got to be able to learn what happens when we put people into home-based quarantine. Australia must reopen. We must get rid of lockdowns; we must re-engage with the world.”

Passengers arriving in Australia are currently required to spend two weeks in a hotel room. But spots in the country’s quarantine system are hard to come by. The border is closed to almost everyone other than returning citizens, many of whom have faced flight cancellations because of the country’s tight limit on the number of arrivals. In July, the cap was halved to 3,000 passengers a week, further complicating some Australians’ efforts to return home.

The announcement of the pilot program comes as New South Wales reaches a key vaccination goal: Half of all residents over age 16 have now received two doses of a Covid vaccine, while more than 80 percent have had at least one. The state is battling one of the country’s most severe outbreaks, with 1,284 new cases and 12 deaths recorded on Friday.

Greg Hunt, the federal health minister, also announced that Australia has surpassed the goal of providing one dose of the vaccine to 70 percent of people over age 16. “It’s a significant and important milestone in protecting Australians and keeping Australians safe,” he said at a news conference on Friday.

Victoria, which neighbors New South Wales, has also administered a first Covid vaccine dose to at least 70 percent of the population over 16, and will ease some restrictions starting late Friday night. The vast majority of businesses remain closed, and a curfew is still in place in Melbourne, the largest city.

Australia will soon begin vaccinating people with the Moderna vaccine, in addition to vaccines produced by AstraZeneca and Pfizer-BioNTech. One million doses of the Moderna vaccine are expected to arrive by the end of the weekend, Mr. Hunt said.

Still, in response to Australia’s ongoing outbreak, New Zealand will not resume quarantine-free travel between the two countries for at least another eight weeks, Grant Robertson, the deputy prime minister, announced on Friday. The country suspended the so-called trans-Tasman bubble in July as cases began to rise in Australia.

The New Zealand city of Auckland, home to one-third of the country’s population, has been under a strict lockdown for one month, as the country attempts to eliminate the Delta variant. New Zealand has so far recorded more than 1,000 coronavirus cases and one death in the latest outbreak.

Credit…Todd Heisler/The New York Times

The Empire State Building, like the city it inhabits, relies on a steady stream of tourists, thriving retail businesses and companies willing to lease its vast amount of office space. The coronavirus pandemic emptied out the attractions, shops and offices, in both the building and the city, for months.

Now, as a promised return to normal has once again been put on hold, the plans being made by the building’s occupants reveal a meaningful cultural shift.

Interviews with dozens of the building’s tenants and an analysis of public records suggest that the role of the office building in America has changed, perhaps permanently, and that local economies once centered on the traditional 9-to-5 workday face an uncertain future. Read the full article at the link below:

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FORT MEADE, Md. — A military judge overseeing the Sept. 11, 2001, case abruptly canceled a hearing on Friday at Guantánamo Bay because of illness related to the coronavirus pandemic, ending this month’s pretrial session a day early.

Lawyers, the defendants and the judge, Col. Matthew N. McCall of the Air Force, were due in court Friday morning for the final day of arguments in a two-week hearing in the case when a clerk sent word, moments before it was to begin at 9 a.m., that the judge had canceled it “in light of recent developments” related to Covid-19 and “in an abundance of caution.”

The concern on Friday was triggered by word reaching Guantánamo before the hearing began that a journalist who had been on base last week discovered on Thursday that he had been infected with the virus. Around the same time, a senior defense lawyer who had experienced a symptom of the virus went to the hospital for testing Friday morning, rather than court, then quarantined until he learned later in the day that he was not infected. Testing of lawyers and other war court personnel who had spent time with the journalist continued into the evening.

The cancellation came on what was to be the final day of the first set of hearings amid the coronavirus pandemic in the long-stalled death-penalty case that accuses Khalid Shaikh Mohammed and four other men of conspiring in the hijackings that killed nearly 3,000 people in New York, Pennsylvania and the Pentagon.

Mr. Mohammed and three of the defendants were already at the court compound on Friday when the judge decided to cancel the hearing. They were to be tested before they were returned to the general population at the prison, although military officials would not provide results of the defendants’ tests, citing health privacy protections.

“The medical care provided to detainees aligns with the Geneva Conventions, which requires medical treatment similar to that available to U.S. service members,” said Maj. Gregory J. McElwain of the Army, a spokesman for the Southern Command.

The Pentagon currently has 39 wartime detainees at Guantánamo, spread across two prison facilities. A few have refused the vaccination. A 100-member military medical staff cares for the prisoners as well as the 1,500 troops and contractors who are assigned to Guantánamo’s detention operations, Major McElwain said.

The naval base in Cuba, with about 6,000 residents and a small hospital, has so far been able to avoid a major coronavirus outbreak through isolation, testing and quarantines. Three residents who traveled to the base this month were discovered after their arrival to be infected by the virus and were quarantined for two weeks, including a fully vaccinated schoolteacher.

Colonel McCall, the judge, is new to the case. He said on Monday that the trial would not begin for at least a year. He had set aside Friday morning to hear arguments over ongoing requests by defense lawyers for information about the defendants’ treatment in C.I.A. custody from 2002 to 2006.

In one request, lawyers for the defendant Ramzi bin al-Shibh were asking the judge to order the government to provide details about the prisoner’s forced shaving while held by the C.I.A. and later at Guantánamo in 2007. Prosecutors have acknowledged that “forced shaving occurred” in January 2007, but declined to name those who did it.

Credit…Brittainy Newman for The New York Times

​Responding to an escalating crisis inside New York City’s notorious Rikers Island jail complex, Gov. Kathy Hochul on Friday signed a measure that will lead to the release of about 200 detainees, many of them being held for parole violations.

The law, known as the Less is More Act, is intended to ease crowding in the jail at a time when severe staffing shortages at the city’s Department of Correction have led to unsafe and unsanitary conditions for detainees and guards. Ten people have died at Rikers since December, several by suicide.

Even though the law does not go into effect until March, Ms. Hochul said she was directing the board of parole to immediately release 191 people who qualify from Rikers Island. They were expected to be released on Friday.

Ms. Hochul also said an additional 200 people serving sentences would be moved from Rikers Island to state prisons over the next five days to ease the burden on the city jail.

But the legislation will still leave Rikers far more crowded than it was last spring, when a wave of releases amid the pandemic dropped the population below 4,000. As of Friday, more than 6,000 people were being held at the jail.

At the same time, coronavirus rates inside the jail appear to be climbing. Correctional health officials first reported an uptick in the prevalence of the virus in mid-August, followed by a spike in cases later that month. After active cases and rates in the jail dropped to near zero in June and July, the seven-day average positive test rate among detainees — 4.36 percent as of this week — is now higher than the city’s 3.92 rate at large.

During a City Council hearing this week to address the conditions at Rikers, officials described a two-pronged catastrophe in the making. About 2,700 staff members — roughly a third of the entire work force — are absent or unable to work on any given day for myriad reasons, leading to a lack of supervision that has caused violence among detainees, and crowding in unsanitary conditions is paving the way for a new surge in coronavirus infections. As of this week, the city said there were 65 active virus cases at the jail.

Only 36 percent of detainees at the jail are fully vaccinated, according to city data.

Credit…Kenny Holston for The New York Times

Peering at a sea of white flags blanketing the National Mall, Dr. Laura A. Valleni recalled the scores of pregnant women who had contracted Covid-19 at her hospital in South Carolina. Babies have been born prematurely, mothers have died and a surge of children has overwhelmed the pediatric unit for the past two months, she said.

“I’ve been grappling with when it became OK for even one person to die of preventable illness,” said Dr. Valleni, a neonatal physician at Prisma Health Children’s Hospital–Midlands in Columbia, S.C. “There’s such tremendous grief.”

She was one of dozens who flocked to the opening on Friday morning of “In America: Remember,” an art installation of hundreds of thousands of flags planted along the mall that honor the more than 670,000 people in the United States who have died from the coronavirus.

The secretary of the interior, Deb Haaland, and the mayor, Muriel E. Bowser, were in attendance as visitors walked among the rows of white flags covering 20 acres of federal park land bordering the White House, the Washington Monument, the National Museum of African American History and Culture and the World War II Memorial.

Angelica Rivera, 33, a call center agent for a health care facility in New Jersey, dedicated a flag to a colleague, Karla Pope, a nurse who died of the virus in January. “I love you! Thank you for everything you did for all of us. My forever work mom,” she wrote.

“We were one of the first health care centers to get vaccines in New Jersey, and she was administering the shots, and then a little while later then she got sick,” Ms. Rivera said. “She got Covid and passed away. Her husband also passed away, and her kids were left without a mom and a dad.”

Other names and messages on flags paid tribute to loved ones: Marshall J. Ciccone, a dedicated husband; Bruce Allen Hutcheson, a health care hero; Betty L. Fox, whose daughter aches for her.

The artist behind the installation, Suzanne Brennan Firstenberg, planted 267,000 flags in Washington last fall to recognize what was then the death toll of the coronavirus in the United States.

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