Credit…Ting Shen for The New York Times

AstraZeneca reiterated on Wednesday that its Covid-19 vaccine was very effective at preventing the disease, based on more recent data than was included when the company announced the interim results of its U.S. clinical trial on Monday.

The company said in a news release that its vaccine was 76 percent effective at preventing Covid-19. That is slightly lower than the efficacy number that the company announced earlier this week.

The new results strengthen the scientific case for the embattled vaccine. But they may not repair the damage to AstraZeneca’s credibility after U.S. health officials and independent monitors issued an extraordinary rebuke of the company for not counting some Covid-19 cases when it announced its initial findings this week.

In a news release on Wednesday, the company said complete results from its 32,000-person study showed that its vaccine was 76 percent effective. On Monday, the company said the vaccine appeared to be 79 percent effective, based on an interim look at 141 Covid-19 cases that had turned up among volunteers before Feb. 17. The latest finding was based on 190 trial participants who had gotten sick with Covid-19.

AstraZeneca said on Wednesday that the vaccine was 100 percent effective in preventing severe disease and 85 percent effective in preventing Covid-19 in people over age 65.

When it unveiled its interim results on Monday, AstraZeneca ignored dozens of recently confirmed Covid-19 cases that had cropped up in trial volunteers before mid-February.

In a letter to the company and federal officials, the independent monitoring board that was helping oversee the clinical trial issued an unusual reprimand of AstraZeneca for appearing to cherry-pick data to make its vaccine appear more effective.

“Decisions like this are what erode public trust in the scientific process,” the letter said. The members of the monitoring board wrote that their statistical modeling had found that the vaccine might have a lower efficacy rate — between 69 and 74 percent — if the Covid-19 cases in question were included in the analysis.

The National Institute of Allergy and Infectious Diseases later disclosed the panel’s concerns via a public statement.

It was not clear why the monitoring board’s projection turned out to be lower than the figure in AstraZeneca’s complete results. The latest results could still change because there are still 14 possible Covid-19 cases that AstraZeneca representatives have not yet classified as actual cases.

Until they received the monitoring board’s letter, AstraZeneca executives weren’t aware that the panel expected them to include those cases in the results disclosed in their news release, according to a person familiar with the executives’ thinking.

The dust-up over AstraZeneca’s U.S. trial results followed a safety scare in Europe that prompted more than a dozen countries to temporarily suspend use of the vaccine. Regulators in Europe said last week that a review had found the shot to be safe after a small number of people who had recently been inoculated developed blood clots and abnormal bleeding. The U.S. trial did not turn up any signs of such safety problems.

People in their cars line up at a mass vaccination stadium site in Glendale, Ariz., in January.
Credit…Juan Arredondo for The New York Times

The push to get Americans vaccinated has picked up momentum in recent days. Governors and public health officials in more than 40 states have said they will meet or beat President Biden’s goal of making every adult eligible for a vaccine by May 1, and at least 30 states plan to start universal eligibility in March or April.

“Everybody in the state vaccinated, that ought to be our goal,” said Gov. Jim Justice of West Virginia, one of five states where everyone 16 and older is already eligible. “I know we’re not going to be able to attain that goal, but we’re going to absolutely be close and that’s what we need to continue to do.”

In Arizona, everyone 16 and older became eligible this week at state-run sites. In Tennessee, universal eligibility was set for April 5. In New Jersey, officials said they expected to meet Mr. Biden’s May 1 goal.

On Tuesday, Texas, Indiana and Georgia announced universal eligibility dates for late March. On Wednesday, Louisiana and Idaho each moved up the date in their states that eligibility would be expanded to those 16 and older. Louisiana set it to Monday and Idaho to April 5. Officials in some other states, including Alabama and Minnesota, have said they expect to meet the president’s May deadline, but have not given exact dates for the eligibility expansions.

Gov. Andrew M. Cuomo of New York has not yet laid out a timeline for opening vaccine eligibility to all adults, saying Wednesday he instead preferred to gradually lower the age threshold for vaccination based on the supply of vaccines made available by the federal government.

As of Tuesday, all people 50 and over can receive the vaccine in New York, in addition to teachers, some essential workers and people with some medical conditions that make them more susceptible to serious illness from the virus.

But a number of essential workers identified by the Centers for Disease Control and Protection as being part of Phase 1c, the third round of priority groups, are not eligible to get vaccinated in the state unless they meet age requirements. Those groups include construction workers and many retail employees, who are generally not able to work remotely during the pandemic.


Eligible only in some counties


Eligible only in some counties


Eligible only in some counties

The rapid expansion of U.S. eligibility comes as about 2.5 million doses of vaccine are administered across the country each day, according to data reported by the C.D.C. About 26 percent of the total U.S. population has received at least one vaccine dose, and about 14 percent have been fully vaccinated. The Food and Drug Administration authorized the Pfizer-BioNTech vaccine for use in people as young as 16 while the Moderna and Johnson & Johnson vaccines can be given to those 18 and older.

The pandemic, however, continues with about 55,000 new cases and 1,000 deaths identified each day. Though the number of new deaths continues to fall, reports of new cases have leveled off in recent weeks as more cases of worrisome variants are detected. Case numbers have been persistently high in the Northeast, and new outbreaks have emerged in Michigan, Minnesota and other states. On Wednesday, the country surpassed more than 30 million cases, according to a New York Times database.

At the White House virus briefing on Wednesday, federal health officials, including Dr. Anthony S. Fauci, again urged caution about the national level of new cases. Dr. Rochelle Walensky, the C.D.C. director, said she was enthusiastic about the pace of vaccinations, but worried about people vacationing for spring break.

With new cases plateauing, “I don’t think you can declare ‘victory’ and say you’ve turned the corner,” said Dr. Fauci, who is the nation’s top infectious disease expert and a pandemic adviser to Mr. Biden. “You’ve got to continue to do what we’re doing: more vaccinations and continue to do public health measures until we actually do turn the corner.”

Many officials hope expanding eligibility and increasing the pace of inoculation could bring those outbreaks under control.

“My thought is that we’re going to see a continued decrease in transmission as we open vaccine eligibility,” said Cindy Prins, an epidemiologist at the University of Florida. “It’s not just a matter of more people getting vaccinated, but the variety of ages and kinds of people who can get vaccinated will reduce that transmission.”

People waiting to receive the coronavirus vaccination at a hospital in Milan this week.
Credit…Alessandro Grassani for The New York Times

When a team of police inspectors descended on a vaccine-manufacturing facility outside Rome over the weekend, they discovered 29 million doses of AstraZeneca Covid-19 vaccines, feeding suspicions that the company was trying to spirit them overseas instead of distributing them in the European Union.

Four days of checks later, Italian officials have accepted AstraZeneca’s explanation that the doses were going through quality control before being shipped to the developing world, and to European countries.

But the cinematic raid — intended to put a little muscle behind European Union threats to make the company stop exporting doses — now stands as a vivid example of just how desperate the hunt for vaccines is getting.

It was also a sign of the continuing tensions between the bloc and those it suspects might be cheating.

“We are in the crisis of the century,” the European Commission president, Ursula von der Leyen, warned last week. “And I’m not ruling out anything for now, because we have to make sure that Europeans are vaccinated as soon as possible.”

On Wednesday the bloc flexed its powers, unveiling emergency rules that grant it broad authority to halt exports of Covid vaccines made in the E.U., escalating an uncharacteristically protectionist stance and risking a fresh crisis in its fragile relations with Britain, a former member.

Britain has been by far the biggest beneficiary of the bloc’s exports, so it has the most to lose. But the rules — if applied — could also be used to curb exports to Israel and others. The legislation is unlikely to affect the United States, and shipments to poor countries through a global consortium will continue.

The moves highlighted the E.U.’s predicament: having launched an ambitious joint vaccine-procurement program last year on behalf of its 27 members, the bloc realized in early 2021 that it had not taken the necessary steps to safeguard supply.

It has been falling behind ever since.

The CNN anchor Chris Cuomo, left, and and his brother, Gov. Andrew M. Cuomo of New York.
Credit…Associated Press

Gov. Andrew M. Cuomo’s administration arranged special access to government-run coronavirus testing for members of his family and other influential people as the pandemic descended on New York last year, according to two people with direct knowledge of the matter.

The move to make testing of people closely tied to Mr. Cuomo a priority was carried out by high-ranking state health officials, one of the people said. It mostly happened in March 2020, while the seriousness of the virus was still becoming clear to the broader public and testing was not widely available.

Among those who benefited from the special treatment was the governor’s brother, the CNN anchor Chris Cuomo, and his family, who were tested several times in the pandemic’s early phase, this person said. The governor’s mother, Matilda Cuomo, and at least one of his sisters were also able to take advantage of the state-administered tests, the two people said.

Chris Cuomo announced on March 31 last year that he had tested positive for the virus.

That the governor’s administration effectively let well-connected people cut the line to determine whether they had been infected with a dangerous virus that was ravaging the state was reported earlier by The Times Union of Albany, N.Y., and The Washington Post.

The revelation comes as Mr. Cuomo confronts the most significant crisis of his political career, with many of his fellow elected New York Democrats calling for him to resign in the face of multiple sexual harassment allegations and questions about his administration’s handling of the virus-related deaths of nursing home residents.

The State Assembly opened an impeachment investigation this week to examine both those issues, while the state attorney general has started a separate inquiry, and federal agents are investigating the nursing home matter.

The revelation of preferential tests could present an additional challenge. State law prohibits officials from using their position to obtain or seek “privileges or exemptions” for themselves or others.

Richard Azzopardi, a spokesman for Mr. Cuomo, did not explicitly deny that the administration had extended special treatment, while also seeking to dispute the notion.

“In the early days of this pandemic, when there was a heavy emphasis on contact tracing, we were absolutely going above and beyond to get people testing,” he said, adding that the effort included “in some instances going to people’s homes — and door to door in places like New Rochelle — to take samples from those believed to have been exposed to Covid in order to identify cases” and to prevent others from developing the disease.

He added: “Among those we assisted were members of the general public, including legislators, reporters, state workers and their families who feared they had contracted the virus and had the capability to further spread it.”

A volunteer at a vaccination site at the Islamic Center of America in Dearborn, Mich., last Friday. 
Credit…Emily Elconin for The New York Times

In a sea of heartening news about the U.S. battle against the coronavirus, some experts are casting worried glances at a cloud on the horizon: Michigan, where new cases and hospitalizations are rising with alarming speed.

The seven-day average of new cases has more than doubled in the last two weeks and tripled in the last month, by far the nation’s fastest rate of growth. The average for hospitalizations has grown 55 percent in the past two weeks.

Michigan is now reporting more new cases each day, relative to the size of its population, than any state except New Jersey.

Epidemiologists and infectious disease experts have yet to settle on clear answers to explain the jumps in Michigan. New cases are rising statewide among all age groups except the very young and those 60 and over, said Sarah Lyon-Callo, the director of the state’s epidemiology bureau.

“However, in the majority of cases, we aren’t able to identify a source of exposure that made them sick,” she added.

There are potential explanations. On Feb. 1, Gov. Gretchen Whitmer eased a ban on indoor restaurant dining and gave a go-ahead to high school and college in-person instruction and high school sports. The state had eased restrictions on theaters, bowling alleys, casinos and other entertainment spots in January.

Michigan’s rate of new cases has been edging upward ever since. Many experts say they believe the public took the easing of restrictions too liberally.

“Because the government has allowed some things to open up, people have viewed that as a good thing to do,” said Dawn Misra, a professor of epidemiology and biostatistics at Michigan State University. “This is a really tricky part of public health messaging. Just because you’re allowed to be in restaurants and other places does not mean they are safe.”

Still, Illinois, a big nearby state that began slowly easing its own stiff restrictions in mid-January, has not seen a significant rise in new cases. Nor has neighboring Indiana, which has placed far fewer limits on its residents than either Michigan or Illinois.

That leads some authorities to pin much of the increase on another culprit: the B.1.1.7 variant of the virus, first identified in Britain, which has proved to be more contagious and potentially deadlier than the original version that spread in the United States.

Federal health officials have expressed concerned about the spread of variants, as the United States remains behind in its attempts to track them. Britain, with a more centralized health care system, began a highly touted genetic sequencing program last year that allowed it to track the spread of the B.1.1.7 variant.

But the Centers for Disease Control and Prevention’s efforts to locate the variants have substantially improved in recent weeks and will continue to grow, in large part because of $1.75 billion in funds for genomic sequencing in the stimulus package that President Biden signed into law this month. Dr. Rochelle Walensky, the agency’s director, told lawmakers last week that between 10,000 and 14,000 test samples were being sequenced each week to locate variants, and that the C.D.C. was aiming for about 25,000.

Officials in Michigan said this week the B.1.1.7 variant has turned up in about one-eighth of the thousands of positive test samples that the state has genetically analyzed so far this year. In mid-March, state health officials said Michigan accounted for 15 percent of all known cases of the variant in the U.S., second only to Florida.

Dr. Lyon-Callo, the state’s chief epidemiologist, said this week that although the B.1.1.7 variant is certainly a player in the increasing rate of new cases, more than half of the 908 confirmed variant cases in Michigan stem from a January outbreak at state prisons. That suggests that the variant is less widespread in the general population than the numbers might indicate.

Dr. Jennifer Morse, the medical director for district health departments in 19 counties in Michigan’s lower peninsula, said the nature of outbreaks in the region suggests that the variant has spread well beyond the limited number of documented cases there.

“We’ve had several outbreaks, and some have been quite rapid and large,” she said. “I do feel it’s very prevalent in our area, looking at how our numbers are going and how it’s spreading.”

But despite the worrisome trend in Michigan, experts offered reasons to be optimistic. The state’s vaccination program is robust; residents of the largest city, Detroit, have embraced masks and other measures that have resulted in lower rates of new cases than in many other places; and, as the weather warms, people are spending more time outside, where getting infected is less likely.

“What’s going very well for us in the U.S. now is seasonality and vaccinations,” said Ali H. Mokdad a professor at the Institute for Health Metrics and Evaluation at the University of Washington. “There’s light at the end of the tunnel. Life will change in the summer — as long as we behave.”

Noah Weiland contributed reporting.

Global Roundup

“It was a mistake,” Chancellor Angela Merkel said of the plan for two extra days of national holiday next week, which she has dropped the day after it was announced.
Credit…Stefanie Loos/Agence France-Presse — Getty Images

BERLIN — Chancellor Angela Merkel scrapped an unpopular plan on Wednesday to shut down the German economy for two extra days over the Easter holidays, reversing her own policy as her government faces widespread anger over its chaotic moves to combat a resurgence of the coronavirus.

Her about-face came less than 36 hours after she had proposed declaring April 1 and 3 “off days,” to effectively extend the country’s Easter vacation to five consecutive days in hopes of halting a recent spike in infections

The suggestion — made after nearly 12 hours of deliberations between Ms. Merkel and the leaders of Germany’s 16 states that dragged into the early hours of Tuesday — was met with an almost immediate backlash, including sharp criticism from opposition politicians and a flood of complaints from a public worn out by a seemingly endless roller coaster of lockdowns and reopenings.

“It was a mistake,” the chancellor said, adding that the suggestion had been made with the best of intentions, aimed at slowing the B.1.1.7 variant, first discovered in Britain, which has been spreading through Germany. That spread has been aided by a sluggish vaccine rollout: Barely 10 percent of German adults have received their first shot, nearly three months after a vaccine developed by a German start-up, BioNTech, became the first in the world to receive approval.

But unlike a year ago, when the chancellor and the governors swiftly agreed to shutter the economy as the pandemic spread across Europe, the proposal to make the Thursday and Saturday before Easter into public holidays met with criticism from business leaders angry at the prospect of losing more revenue and German citizens angry at the idea they have to spend their spring holiday at home for the second year in a row.

“We have to succeed in slowing the spread of the third wave of the coronavirus,” the chancellor said, thanking all Germans who are following social distancing and masking rules.

This was the latest in a series of abrupt turns by Ms. Merkel’s government, after her health minister abruptly announced the country was halting vaccinations with AstraZeneca last week, only to reinstate them after the European drug regulator, the European Medicines Agency, cleared it for use.

Yet despite the confusion created by the suggestion of extending the holidays, some acknowledged that simply going back on the plan would do little to help the country slow the spread of the coronavirus. Germany saw 15,813 new infections on Wednesday, continuing a sharp rise over recent weeks.

“Instead of more protection against the third wave, we now have less!” said Janosch Dahmen, a medical doctor who serves as a lawmaker for the Greens, said on Twitter. “The extended break over Easter is now off the table. Even if it was half-baked, today’s decision made fight against the virus worse, even though it tried to make it better.”

In other news around the world:

  • Belgium will tighten restrictions on Friday as it faces rising numbers of hospitalizations and new cases. Hairdressers and beauty salons will be closed until April 25, and other nonessential businesses will be allowed to open to the public only by appointment. Alexander de Croo, the country’s prime minister, called the new measures “an Easter break.” Schools’ spring break will be extended by one week, so students will not return to in-person instruction until April 19

  • In India, citing rising case numbers and increased domestic demand, officials have decided to halt AstraZeneca exports, officials told the BBC. Delayed vaccine shipments from the world’s largest vaccine producer, the Serum Institute of India, have slowed Britain’s vaccination program, and India’s decision to halt its exports could further affect vaccine distribution in other countries that depend on the country’s resources.

Teaching a science class via Zoom last year in Durham, N.C. A year into the pandemic, America’s school system remains severely disrupted.
Credit…Pete Kiehart for The New York Times

Under President Donald J. Trump, the federal government did little to gauge the impact of the pandemic on the nation’s education system. President Biden promised to change that, and on Wednesday, his Department of Education released the first federal survey of how American public schools have operated amid the coronavirus pandemic.

The results paint a picture of a school system that remained severely disrupted as the pandemic neared its first anniversary.

It found that in January, three-quarters of school buildings were open at least partially for in-person learning in the fourth and eighth grades, the two grade levels examined by the survey. Nevertheless, 43 percent of fourth graders and 48 percent of eighth graders were learning fully remotely. Only 28 percent of eighth graders and 38 percent of fourth graders were attending full-time, in-person school; the rest were on hybrid schedules, receiving a mixture of in-person and virtual instruction.

Racial disparities were stark. The majority of Black, Hispanic and Asian-American fourth graders were learning fully remotely, compared to only a quarter of white fourth graders. About half the white fourth graders were in full-time, traditional school.

Children with disabilities were only slightly more likely to be learning in-person than others, despite schools reporting that they had prioritized this population for classroom time.

“It’s sobering,” said Robin Lake, director of the Center on Reinventing Public Education, a research group that has spent the past year gathering its own, widely cited data on how school districts are functioning. “The data point us to the strong likelihood that the effects from lack of live instruction will add up to significant challenges for kids.”

In line with previous research, the survey found that urban schools, which serve large numbers of nonwhite students, were less likely to offer full-time, in-person schedules. But there is also evidence that significant numbers of nonwhite parents are opting for remote learning even when other options are available, in part because they are more concerned about the health risks of returning their children to school buildings.

The quality of remote learning varied widely, according to the federal survey. More than 1 in 10 students were offered less than two hours per day of live instruction from teachers. In some states, such as Oklahoma and Idaho, only a small percentage of remote learners received more than two hours of live teaching daily.

The survey is based on a representative sample of schools, and will be updated monthly throughout the academic year. Future surveys will look at additional grade levels.

An Air Canada employee, Mohamed Gaballa, completing a rapid test at Toronto Pearson Airport in January.
Credit…Tara Walton for The New York Times

A team of Canadian researchers who brought together some of that country’s largest businesses to scale up a rapid coronavirus testing program is now trying to replicate its success in the United States, with the aim of reviving the economy and getting thousands of Americans back to work.

The organizers of the new program, called the U.S. Rapid Action Consortium, will announce on Wednesday that they are trying to recruit 12 companies to screen asymptomatic employees with rapid antigen tests on a routine basis. Four companies have signed on so far, including Air Canada and Scotiabank. Both participate in the Canadian program, which also began with 12 firms and has grown to include 400.

The consortium hopes that by joining forces, companies in the United States will be able to increase their purchasing power and quickly learn how to use rapid tests to prevent outbreaks and reopen shuttered businesses.

“Industry is essentially saying, ‘We need to act now. This remains a crisis for us. Every day that our employees are not at work is another day that our business isn’t optimized,’” said Dr. Michael Mina, a Harvard University epidemiologist and expert in rapid testing who has been asked to advise the group.

But the consortium may face obstacles. Rapid tests are in short supply in the United States, and the Biden administration recently announced it intends to spend $10 billion to ramp up rapid coronavirus testing in schools. Dr. Mina said it might “prove difficult to get the fast testing in a way that the companies are really hoping because of the limited supply.”

The Canada initiative was organized by Ajay Agrawal, the founder of the University of Toronto’s Creative Destruction Lab, which helps science and technology start-ups. In the United States, the lab is partnering with Covid Collaborative, a bipartisan association of policy experts, and Genpact, a global professional services firm that has operations in Texas and is also involved in the Canadian effort.

“The ultimate goal is to take the cost of this down dramatically and just reopen the economy much faster and for our employees, make it a safe place to come to work,” Darren Saumur, Genpact’s global operating officer, said in an interview.

In Canada, where the program has been running for two months, employees periodically stop into screening stations set up outside their workplaces and take rapid antigen tests.

These tests are relatively cheap and can return results in 15 minutes, but are less sensitive and more prone to false negatives than polymerase chain reaction, or P.C.R., tests that are the gold standard for detecting the coronavirus. Employees who test positive on the rapid antigen test are referred for a follow-up P.C.R. test.

Between January 11 and March 18, the Canadian program administered more than 21,000 rapid tests across 42 different sites. Just 19 returned positive results; of those, 16 were confirmed as positive by P.C.R. testing, consortium officials say.

Participating companies must pay for their own tests, but the consortium will provide a detailed “playbook” to help companies set up their programs, as well as operational support. Companies that participate in the first cohort will be asked to help the next group of companies implement their programs.

“You have to promise that you’re going to pay it forward,” Mr. Agrawal said.

Crowds gather in the street while a speaker blasts music an hour past curfew in Miami Beach, Fla., over the weekend. The city extended a curfew after police struggled to contain unruly crowds of spring break tourists.
Credit…Daniel A. Varela/Miami Herald, via Associated Press

College students on spring break and tourists who had mostly stayed inside for a year descended by the tens of thousands on Miami Beach, a vacation hot spot that — along with the rest of Florida — has lifted most Covid-19 restrictions, opening its restaurants and clubs and bars.

But the huge crowds that gathered in the city’s famous 10-block beachside entertainment district starting in late February became unruly at times, with fights breaking out and gunshots fired into the air, causing stampedes.

In the weeks since the influx began, more than 1,000 people have been arrested, one-third or more of them on drug and alcohol consumption charges. The police have seized more than 100 guns. And there has been some violence: In perhaps the most serious case, two male visitors are accused of drugging and raping a woman who later died.

But the raucous partying was largely nonviolent, city officials say. And for that reason, many Black leaders in town have questioned what happened next.

On Saturday, the city declared a state of emergency, and a few hours later, a military-style armored vehicle and police officers in riot gear moved down Ocean Drive, blaring sound cannons and firing pepper balls to disperse the crowds and enforce the newly declared curfew.

The resulting video images of heavily armed police officers cracking down on unarmed crowds reminded many people of last summer’s protests against police brutality, prompting local Black leaders to criticize Miami Beach city officials for being poorly prepared for the chaos and for being unnecessarily heavy-handed in their response.

The city has been accused of racism before in its handling of large Black crowds, particularly during Memorial Day weekends over the years.

The suicide of Kent Taylor, the founder and chief executive of the Texas Roadhouse restaurant chain, has drawn attention to a possible link between Covid-19 and tinnitus, the medical term for a constant ringing in the ears.

Mr. Taylor had a variety of symptoms following his illness, including severe tinnitus, his family said in a statement, adding that his suffering had become “unbearable.”

Whether tinnitus is linked to Covid-19 — and if so, how often it occurs — is an unanswered question. Neither the World Health Organization nor the Centers for Disease Control and Prevention describes tinnitus as a symptom, although auditory problems are common in other viral infections.

But tinnitus is on the list of symptoms of “long Covid” published by the National Health Service in Britain, along with fatigue, shortness of breath, dizziness and more. And a few recent case reports and studies have hinted at a potential link.

Credit…Ron Bath/Texas Roadhouse

A study published on Monday in the Journal of International Audiology that looked at nearly 60 case reports and studies found that 15 percent of adults with Covid-19 reported symptoms of tinnitus. The authors believe that the respondents were describing either a new condition or a worsening one, though they are following up with the 60 or so researchers to be certain about how the surveys were worded.

“In the 24 hours since we published, I’ve received about 100 emails,” said Kevin Munro, a professor of audiology at the University of Manchester and a co-author of the study. “Almost of all of them were people saying, ‘I was so happy to read about this, because my doctor thought I was crazy when I mentioned tinnitus and now I know I’m not the only one.’”

There is also some evidence that Covid-19 can aggravate symptoms among people who already had tinnitus. A study published late last year in the journal Frontiers in Public Health surveyed 3,100 people with tinnitus and found that 40 percent of the 237 respondents who had contracted Covid-19 reported that their symptoms were “significantly exacerbated” following the infection.

“There are a lot of viruses that have an impact on the ears, including measles, mumps and rubella,” said Dr. Eldre Beukes, the audiologist at Anglia Ruskin University in England who led the study. “It could also be the case that medication taken to combat Covid is making tinnitus worse. And there is a well-known link between tinnitus and stress.”

A trolley carrying BioNTech vaccines at Hong Kong International Airport in February.
Credit…Pool photo by Jerome Favre

Hong Kong on Wednesday suspended use of the Pfizer-BioNTech vaccine after packaging defects ranging from cracked containers to loose caps were discovered in one batch of doses. The pause dealt a major blow to a city already struggling to inoculate its seven million residents against Covid-19.

Health officials called the halt a precaution, saying that none of the defective vials had been administered to patients and that they had found no health risks.

But if the suspension persists, the Chinese territory may not have enough shots to protect its population while the coronavirus continues to spread. Hong Kong officials were counting on 7.5 million doses of the vaccine, developed by Pfizer of the United States and BioNTech of Germany, to help fill their needs.

The discovery has unleashed a hunt for the origin of the defects, as well as questions about whether more might be out there. The doses were manufactured at BioNTech’s facilities in Germany, while a Chinese company called Fosun Pharma was in charge of transporting, storing and distributing the shots in Hong Kong.

“I’m confused as to why this is being reported for the first time in Hong Kong and we haven’t heard about it elsewhere,” said Benjamin Cowling, the division head of epidemiology and biostatistics at the University of Hong Kong.

“Was there anything special about this particular batch? Presumably they were manufactured in exactly the same way that the other batches have been manufactured in Germany.”

In a statement on Wednesday, BioNTech said the batch in question had been sent only to Hong Kong and Macau, another Chinese territory nearby, where the authorities also suspended use of the vaccine.

The company said it was investigating the source of the problem but added that, “At this point, we have no reason to believe there is any safety risk posed to the population.”

Even before the defects were found, Hong Kong’s inoculation drive had been plagued by public doubts. Vaccination bookings had fallen after reports that several people died after receiving the other vaccine Hong Kong is using, which is made by Sinovac, a Beijing company.

The Hong Kong government has found no direct link between the shots and the deaths. But trust in the government has fallen since mainland Chinese officials tightened their control over the former British colony following antigovernment protests in 2019.

In January, a poll of 2,733 residents showed that only 39 percent of Hong Kong residents were willing to take a Covid-19 vaccine.

“There are some important risks here that this will further undermine confidence in the vaccines that are available,” said Karen Grépin, an associate professor at the School of Public Health at the University of Hong Kong.

The Olympic rings in Tokyo this month.
Credit…Eugene Hoshiko/Associated Press

From the moment that Japan pitched to host the 2020 Olympic Games, its organizers have framed it as a symbol of recovery.

Now, as the organizers press ahead with plans to hold the Tokyo Olympics this summer, the event itself threatens to become a trial.

A series of challenges have besieged the Games. Even as the organizers decided last week to bar international spectators, epidemiologists warn that the Olympics could become a superspreader event. Thousands of athletes will descend on Tokyo from more than 200 countries while much of the Japanese public remains unvaccinated.

In polls, close to 80 percent say the Games should be postponed again or canceled outright.

The financial hazards are also significant — the Olympic budget has swollen to a record $15.4 billion, increasing nearly $3 billion in the past year alone and adding to longstanding doubts about whether Olympic Games pay off for host nations. Without foreign spectators, there is now little upside for hotels, restaurants and other tourist attractions.

And the Tokyo organizing committee has been swamped by leadership chaos, with both the president and creative director resigning over the past month after making sexist remarks.

In the telling of the Olympic organizers, staging the Games this summer is something close to a moral imperative. The president of the Tokyo organizing committee, Seiko Hashimoto, recently cited the “significant challenges” facing the world and the responsibility of the Olympics “to build a legacy for the future society.”

But money, national pride and political obduracy are also at play.

Then there is the matter of China. The Beijing Winter Olympics are less than a year away, and Tokyo wants bragging rights for hosting the first post-pandemic Games. If the Olympics fell through in Japan but were staged in China, that could give the Beijing government more fuel to assert that its authoritarian system is superior.

Whatever the outcome, they could have profound ramifications for the entire Olympic movement, which has relied for decades upon a promise of inspiration and civic pride to support enormous expenditures and increasingly onerous demands on host cities.

Moncef Slaoui, who headed the Trump administration’s vaccine acceleration efforts from May until January, in the Rose Garden at the White House last year.
Credit…Kevin Lamarque/Reuters

GlaxoSmithKline, the pharmaceutical company, said on Wednesday that it had fired Moncef Slaoui, the former head of Operation Warp Speed, from his position as chairman of Galvani Bioelectronics because of allegations of sexual harassment and inappropriate conduct.

The company cited allegations made by a female employee regarding incidents that occurred at GSK several years ago. The decision to terminate Dr. Slaoui is effective immediately, GSK said in a statement. GSK is the majority shareholder in Galvani Bioelectronics, a medical research company that is a joint venture with Verily Life Sciences.

In statement issued late Wednesday afternoon, Dr. Slaoui apologized “unreservedly to the employee concerned,” and to his wife and family “for the pain this is causing.”

“I am deeply sorry for any distress caused,” he said, adding that he will take leave from his professional responsibilities “to focus on my family.”

GSK said it had received a letter accusing Dr. Slaoui, 61, of sexual harassment and had asked a law firm to investigate. The investigation confirmed the allegations, GSK said, adding that the investigation is continuing.

Emma Walmsley, chief executive of GSK, sent a letter to employees on Wednesday saying the company had learned of the allegations in February. Neither she nor the GSK board provided details of the allegations.

“Dr. Slaoui’s behaviours represent an abuse of his leadership position and violate our company policies, our values, and our commitment to trust,” she wrote.

“Protecting the woman who came forward and her privacy has been a critical priority throughout this time,” she added. “This will continue. I respect and admire her courage and strength. I’ve spent many nights lately putting myself in her shoes.”

Dr. Slaoui came to Operation Warp Speed from GSK, where he was in charge of developing vaccines. He headed the Trump administration’s vaccine acceleration efforts from May until January.

He drew criticism for owning stock in Moderna, maker of a coronavirus vaccine, and in GSK, which was pursuing a vaccine with Sanofi. The federal government invested $2.1 billion in the latter effort.

Dr. Slaoui eventually agreed to give up his stock in Moderna but not in GSK. To sidestep ethics regulations that would have prohibited him from owning that stock, the Trump administration designated him as a contractor.

After leaving the administration, Dr. Slaoui joined a new company, Centessa Pharmaceuticals, made up of ten biotech companies with $250 million from investors, as chief scientific officer.

Roselyne Bachelot, the French culture minister, leaving a cabinet meeting at the Élysée Palace in January.
Credit…Ludovic Marin/Agence France-Presse — Getty Images

France’s culture minister, Roselyne Bachelot, has been hospitalized with Covid-19, the authorities said on Wednesday, as the country faced a new wave of coronavirus infections that threatens to overwhelm its hospitals.

Ms. Bachelot, 74, is the second member of the government to be admitted to a hospital because of the virus, and the latest in a series of senior officials to become ill. President Emmanuel Macron tested positive in December.

A statement from Ms. Bachelot’s office said that her condition was “stable and does not raise concern,” and that her doctor had “recommended increased hospital surveillance for the next few days.” She said on Saturday that she tested positive after experiencing respiratory problems.

The news that she was infected touched off a controversy in France. Ms. Bachelot went to a closed performance for invited guests at the Paris Opera on Friday and posed for close-up photos with unmasked performers afterward, according to the newspaper Libération. She wore a mask the entire time, but social distancing rules appeared to have been broken, raising the possibility that performers and other workers may have been put at risk.

Unions representing workers in the arts have criticized Ms. Bachelot because cultural institutions have mostly been closed since October, when rising coronavirus cases prompted a lockdown, the country’s second of the pandemic. Protesters recently occupied several theaters to demand that they be reopened.

New case reports in France have generally been trending upward since early December, and have climbed sharply this month, according to a New York Times database. The country’s hospitals are being severely strained by an influx of coronavirus patients, and intensive care units in the Paris region are already filled beyond their official capacity.

Martin Hirsh, the director of Paris’s public hospitals, wrote in an email to employees on Wednesday that more new patients arrived at intensive care units the day before than on any day since the pandemic’s first wave last spring.

The French government put several regions, including Paris, under a new lockdown last week that forced businesses that are considered nonessential to close, and ordered residents to limit their outdoor activities to places within six miles of their homes.

Officials at the Environmental Protection Agency said an accounting was necessary to reassure federal scientists that their work would be heeded in the future.
Credit…Stefani Reynolds for The New York Times

The Biden administration is taking the unusual step of making a public accounting of the Trump administration’s interference in science, drawing up a list of dozens of regulatory decisions that may have been warped by political imperatives.

The effort could buttress efforts to unwind pro-business changes in regulations that were made over the past four years, while boosting the morale of federal scientists and researchers battered by four years of disregard.

At the Environmental Protection Agency, President Biden’s political appointees said they felt that an honest accounting of past problems was necessary to assure scientists that their findings would no longer be buried or misused.

“Manipulating, suppressing, or otherwise impeding science has real-world consequences for human health and the environment,” the E.P.A. administrator, Michael Regan, said in an agencywide email on Tuesday. “When politics drives science, rather than science informing policy, we are more likely to make policy choices that sacrifice the health of the most vulnerable among us.”

In a blunt memo this month, one senior Biden appointee said that political tampering under the Trump administration had “compromised the integrity” of some of the agency’s scientific work. She cited examples like studies that showed the harm done by dicamba, a herbicide used in popular weedkillers like Roundup that has been linked to cancer; political leaders discounted the studies and then ruled that dicamba’s effectiveness outweighed its risks.

The broader list of decisions that staff members say violated scientific integrity is expected to reach about 90 items, according to one person involved in the process.

President Donald J. Trump’s well-documented attacks on science include doctoring a forecast map with a black Sharpie to avoid acknowledging that he was wrong about the path of a hurricane, and then pressuring scientists to back his false claim; meddling in federal coronavirus research; and pressuring regulators to hurriedly approve Covid 19 vaccines and treatments. Those actions prompted bipartisan concern during his administration.

The E.P.A. was the scene of some of the administration’s most questionable decisions.

Mr. Trump’s first choice to head the agency, Scott Pruitt, took down the E.P.A.’s web page on climate change (which has since been replaced); fired and barred independent scientific advisers who had received grants from the E.P.A. (a policy that a court ultimately found to be illegal) and then replaced them with industry representatives; and rolled back scientifically supported policies like limiting pollution from trucks with rebuilt engines after meeting with executives and lobbyists.

A drive-through vaccination site in Cleveland, Miss.
Credit…Rory Doyle for The New York Times

When Bobby Wayne, 64, called a Mississippi state hotline this week to find out where he could get the Covid-19 vaccine, he says, an operator gave him incorrect — and unnerving — information.

“This is the way she put it to me: They had no documentation that the vaccine was effective,” Mr. Wayne recalled. “And then she asked me did I still want to take it.”

When he replied yes, the operator told him that there were no appointments available and that he should call again the next morning, he said.

The Mississippi State Department of Health chalked the misinformation up to confusion, saying it was the result of “miscommunication” over a misleading script given to the hotline operators.

The script was referring to pregnant women, women who are lactating and people with compromised immune systems. It asked: “Do you still want to be vaccinated with an understanding there are currently no available data on the safety or effectiveness of Covid-19 vaccines, including Moderna Covid-19 vaccine, in pregnant people, lactating people or immunocompromised people?”

Most experts agree that the risks to pregnant women from Covid-19 are far greater than any theoretical harm from the vaccines. Doctors have also said they believe that the vaccines are safe for people with autoimmune conditions.

Liz Sharlot, a spokeswoman for the state health department, said that the wording in the script could be confusing “when read out of context.”

“We are replacing this confusing and misleading language,” she said in a statement.

However, Ms. Sharlot said the operators had never been told that there was no documented proof that the Moderna vaccine or any other vaccine authorized for use by the Food and Drug Administration worked.

“Just the opposite is true,” she said. “Both Moderna and Pfizer have high efficacy rates.”

Mr. Wayne’s daughter, Elizabeth Wayne, an assistant professor of biomedical engineering at Carnegie Mellon University, complained on Twitter about her father’s conversation with the hotline operator, equating it with “violence.”

“It’s dangerous,” Dr. Wayne said in an interview. “There is a therapy available. There is a way to treat something, and you’re making it difficult for them to have access to that treatment so it’s increasing the likelihood they may become sick.”

The Mississippi Free Press reported the story after Dr. Wayne posted about her father’s experience on Twitter.

Dr. Wayne said she was pleased that the health department appeared to take her concerns, and her father’s, seriously.

“I think it was a really good example of the State Health Department trying to reach out because they actually want to restore faith” in the vaccine, she said.

Mr. Wayne said he got his shot on Wednesday morning.

“I feel a whole lot better,” he said.

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

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

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

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

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

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


Eligible only in some counties


Eligible only in some counties


Eligible only in some counties

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Stanford has used virtual reality technology to teach anatomy.
Credit…Noah Berger/Reuters

For generations, medical students were initiated to their training by a ritual as gory as it was awe-inducing: the cadaver dissection. But amid the pandemic, the cadaver dissection — like many hands-on aspects of the medical curriculum — turned virtual, using a three-dimensional simulation software.

Of the country’s 155 medical schools, a majority transitioned at least part of their first- and second-year curriculums to remote learning during the pandemic. Nearly three-quarters offered lectures virtually, according to a survey by the Association of American Medical Colleges, and 40 percent used virtual platforms to teach students how to interview patients about their symptoms and take their medical histories.

Though the cadaver dissection posed a trickier challenge, nearly 30 percent of medical schools used online platforms to teach anatomy.

Medical students in many states have been eligible for and able to receive the vaccines, but some have not yet fully shifted back to in-person learning, with school administrators saying they preferred to wait until Covid-19 case rates decline further. Some in-person training, like practicing clinical skills, has largely resumed.

Medical schools adapted in the past year with inventive approaches to clinical training. Case Western Reserve University School of Medicine and Stanford used virtual reality technology to teach anatomy. The Vagelos College of Physicians and Surgeons at Columbia University offered students the opportunity to shadow doctors virtually, sitting in on telemedicine appointments.

The Keck School of Medicine, at the University of Southern California, opted to have faculty members dissect cadavers while wearing body cameras so students could watch remotely. The cadavers were also imaged using three-dimensional scanners, so students could practice manipulating the sorts of images produced by magnetic resonance imaging and CT scans.

Educators are aware that for all the promise of new technologies, there’s a sense of loss for students who aren’t able to be in hospitals, classrooms and dissection laboratories in person.

Some students, though, pointed to a silver lining in their virtual medical training: They’ve become adept at speaking with patients about sensitive issues over video, a lesson very likely to prove essential as the field of telemedicine expands.

Jozanne Berdan, a student, helps direct people arriving for coronavirus testing on the campus of the University of California, Davis.
Credit…Max Whittaker for The New York Times

A new analysis suggests that schools and colleges, large companies and other organizations that want to keep themselves safe with frequent mass testing should think beyond their own personnel.

By dedicating a substantial portion of their tests to people in the surrounding community, they can reduce the number of Covid-19 cases among their members by as much as 25 percent, researchers report in a new paper, which has not yet been published in a scientific journal.

“It’s natural in an outbreak for people to become self-serving, self-focused,” said Dr. Pardis Sabeti, a computational biologist at Harvard University and the Broad Institute who led the analysis. But she added, “If you’ve been in enough outbreaks, you just understand that testing in a box doesn’t makes sense. These things are communicable, and they’re coming in from the community.”

The study has “really profound implications, especially if others can replicate it, said David O’Connor, a virologist at the University of Wisconsin, Madison, who was not involved in the analysis but reviewed a draft of the paper.

Early in the pandemic, when testing resources were in short supply, many colleges proposed intensive, expensive testing regimens focused entirely on their own campuses. When they sought Dr. Sabeti’s advice, she said, she told them they ought to test friends, relatives and neighbors of their students and employees as well.

It was not an easy idea to sell without data on its effectiveness, so Dr. Sabeti and her colleagues developed an epidemiological model to simulate how a virus might spread through a midsize institution, Colorado Mesa University, and what would happen under different testing policies. They found that allocating some tests to community contacts would significantly reduce the expected number of Covid cases on campus.

C.M.U. now offers free tests to all of its students’ self-reported contacts, and runs a testing site that is open to local residents, according to Amy Bronson, a co-chair of the university’s Covid-19 task force and an author of the paper.

And in November, the University of California, Davis, began offering free coronavirus tests to anyone who lives or works in that city.

“A virus does not respect geographic boundaries,” said Brad Pollock, an epidemiologist at U.C. Davis who directs the project. “It is ludicrous to think that you can get control of an acute infectious respiratory disease like Covid-19, in a city like Davis that hosts a very large university, without coordinated public health measures that connect both the university and the community.”

Krispy Kreme said this week that it would give one glazed doughnut per day this year to anyone who provides proof of a Covid-19 vaccination.
Credit…Amr Alfiky/The New York Times

Businesses across the United States and beyond are offering free food, merchandise and other stuff to people who receive a Covid-19 vaccine. The perks include complimentary rides, doughnuts, money, arcade tokens and even marijuana.

Chobani is providing free yogurt at some vaccination sites. And Krispy Kreme said on Monday that for the rest of the year, it would give one glazed doughnut a day to anyone who provides proof of a Covid-19 vaccination.

The Krispy Kreme initiative does not entitle vaccinated Americans to endless doughnuts, as the company’s chief executive, Michael Tattersfield, seemed to imply in an interview with Fox News — just one a day, as the company notes on its website.

In a promotion it is calling “Tokens for Poke’ns,” Up-Down, a chain of bars featuring vintage arcade games, is offering $5 in free tokens to guests who present a completed vaccination card. Up-Down, which has six locations in five Midwestern states, is extending the offer to guests who visit within three weeks of their final dose.

Cleveland Cinemas, a movie-theater chain in Ohio, is offering a free 44-ounce popcorn at two of its locations to anyone who presents a vaccination card through April 30.

The Market Garden Brewery in Cleveland is offering 10-cent beers to the first 2,021 people who show a Covid-19 vaccine certificate. “Yes, you read that right,” the brewery says on its website. “Ten Cents.”

At the Greenhouse of Walled Lake, a medical marijuana dispensary in Michigan, anyone 21 or over who gets a Covid vaccine can pick up a prerolled joint until the end of the month.

Overseas, the city of Tel Aviv set up a mobile vaccination clinic at a bar last month, and offered free beer and shots of nonalcoholic peach juice to those who received a shot, The Times of Israel reported.

Other incentives target people in vulnerable groups. Uber, for instance, has agreed to provide 10 million free or discounted rides to seniors, essential workers and others in countries across North America, Europe and Asia to help them get to vaccination centers.