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Credit score…Nipah Dennis/Agence France-Presse — Getty Pictures

The worldwide sharing program designed to make vaccine entry extra equal delivered its first main cargo of doses on Wednesday to the West African nation of Ghana, ramping up the biggest mass immunization marketing campaign in historical past.

At this time marks the historic second for which we now have been planning and dealing so onerous,” mentioned Henrietta Fore, the chief director of UNICEF. “Within the days forward, frontline staff will start to obtain vaccines, and the subsequent part within the struggle in opposition to this illness can start.”

The primary cargo of 600,000 doses was packed up and labeled in India, then flown to Accra, the Ghanaian capital.

Ghana and different West African international locations are to start vaccinations in coming days, based on officers, the primary of 92 low and middle-income international locations that may obtain free vaccines via Covax, a vaccine-sharing initiative.

The aim is for Covax to ship some two billion doses of Covid-19 pictures this yr, which officers mentioned would make it the biggest vaccine procurement and provide operation in historical past.

The cargo arrived in West Africa as research had been launched suggesting that the unfold of the virus within the area has been a lot wider than official numbers present.

Not less than one in 5 individuals in Lagos, Nigeria, may have had contracted the coronavirus by October final yr, based on findings simply launched by the Nigeria Heart for Illness Management, an an infection fee far larger than the one reported via the nationwide surveillance system. A research in Accra launched in November had comparable findings.

Many public well being officers have criticized the unequal distribution of vaccines — with rich nations already delivering tens of tens of millions of doses and buying huge reserves for his or her populations.

As an example, whereas at the least 44.5 million Individuals and round 18 million individuals in Britain have already acquired a shot, as of final week greater than 130 international locations had but to vaccinate a single particular person. The Ghana cargo covers simply 1 % of the inhabitants.

The United Nations secretary-general, António Guterres, mentioned final week that the distributions had been “wildly uneven and unfair.”

And high-income international locations should not respecting contracts below Covax and are competing with them, decreasing the variety of doses the initiative should buy, Dr. Tedros Adhanom Ghebreyesus, the top of the World Well being Group, mentioned on Tuesday.

The pandemic is not going to finish, he added, till everyone seems to be vaccinated.

“This isn’t a matter of charity,” he mentioned. “It’s a matter of epidemiology.”

Final week, the group of rich industrialized nations often known as the Group of seven introduced that they’d intensify their cooperation with the worldwide vaccination drive and raised their general dedication to the hassle to $7.5 billion.

However Dr. Tedros mentioned that there remained a financing hole of $23 billion.

President Emmanuel Macron of France referred to as for much more pressing motion on Friday, saying Europe and america ought to ship as much as 5 % of their vaccine provides to creating nations.

However even when issues go based on plan, vaccinating the overwhelming majority of the world’s most weak individuals this yr will probably be a frightening problem.

Ghana, a nation of greater than 30 million individuals, will get sufficient vaccines to cowl solely about 20 % of its inhabitants by the tip of 2021. It should purchase tens of millions extra doses individually.

Poorer international locations don’t pay to buy vaccines and injection units below Covax, at the least for as much as 20 % of the inhabitants. However they do should pay the prices of supply inside the nation.

To obtain vaccines, international locations needed to submit plans saying who they needed to immunize, how they’d go about it and the way they’d monitor vaccinations. In addition they needed to signal an indemnity settlement with the vaccine producer.

“No nation was prioritized,” mentioned Benjamin Schreiber, UNICEF’s coordinator for the Covax program.

4 international locations eligible to use for vaccines below Covax didn’t achieve this: Burundi, Eritrea, Madagascar and Tanzania.

United States › United StatesOn Feb. 23 14-day change
New instances 71,737 –37%
New deaths 2,315 –23%

World › WorldOn Feb. 23 14-day change
New cases 367,421 –16%
New deaths 10,778 –23%

U.S. vaccinations ›

Where states are reporting vaccines given

Handing out literature about domestic violence in the Bronx in April.
Credit…Stephanie Keith for The New York Times

A meta-analysis of studies released on Wednesday affirmed what social workers, educators and law enforcement officials have warned about for months: Stay-at-home orders exacerbated domestic violence. Reports increased more than 8 percent since the widespread lockdowns in the United States began last spring.

The report, released by the University of Miami and the National Commission on Covid-19 and Criminal Justice, is based on 18 studies covering communities in the United States and overseas. It compared changes in the number of domestic violence events before and after lockdowns began.

The studies measured changes in police calls for service, crime and incident reports, domestic violence hotline registries, and health records, using data derived from official records. The studies did not use qualitative or anecdotal evidence.

“We were able to quantify, in large and small U.S. cities and some worldwide, a broad view of the impact that the pandemic has had on domestic violence,” Alex R. Piquero, a sociology professor at the University of Miami and the lead author of the report, said in an interview.

Even before this study, with only limited data available, the situation was deemed so grave that the World Health Organization and the United Nations called for action to protect children from violence amid lockdowns.

When the researchers factored in data from a few countries outside the United States — including Argentina, Italy, Mexico and Sweden — they found that the rate of domestic violence was only slightly lower.

Given that domestic violence is one of the most underreported crimes, Mr. Piquero said that the report’s findings were most likely an underestimate.

“This is a floor, not a ceiling, with regard to the true veracity of what the pandemic did to domestic violence,” he said.

The report reiterated what was already evident in anecdotal accounts of domestic violence during the pandemic: The lockdowns forced adults and children to stay in close quarters with their abusers, and the orders cut them off from friends, neighbors, colleagues and others who could report signs of abuse or help victims escape violent situations.

The economic impact of the pandemic also exacerbated factors already associated with domestic violence, including male unemployment, financial insecurity, and alcohol and other substance use, according to the study.

The group that compiled the study, the National Commission on Covid-19, was created by the Council on Criminal Justice, a think tank that studies criminal justice policies. It is led by a bipartisan pair of former attorneys general: Alberto Gonzales, a Republican, and Loretta Lynch, a Democrat.

The commission aims to assess the pandemic’s impact on the justice system; it includes judges, law enforcement officials, a defense lawyer, a researcher, and community and religious leaders.

The commission said that its findings highlighted a serious need for more domestic abuse prevention and services for survivors. It said the need was especially urgent among historically marginalized groups and those likely to be disproportionately isolated during the pandemic, such as older adults, people struggling with mental illness and chronic health conditions, and women and children with past experiences of violence and abuse.

Pete Lee had to quarantine at the Roaders Hotel in Taipei, Taiwan, upon his arrival from San Francisco.
Credit…Pete Lee

If you’re lucky enough to have traveled by air to, say, Kauai or the British Virgin Islands, your quarantine may include the option of roaming relatively freely on a resort’s expansive grounds while waiting for a negative coronavirus test.

But travel by air to Australia, New Zealand, mainland China or Tunisia, and you will generally find yourself confined to your room, 24 hours a day, for up to two weeks (assuming you test negative, that is). And with some exceptions, you are footing the bill — quarantine in New South Wales, Australia, for example, costs 3,000 Australian dollars, or about $2,300, for a two-week quarantine for one adult, and up to 5,000 dollars for a family of four.

Quarantine might seem manageable for those who have been living under shelter-in-place orders and working from home. Pete Lee, a filmmaker based in San Francisco, was not concerned about the quarantine when he flew to Taiwan for work and to visit family.

“I was a little bit cocky when I first heard about the requirement,” Mr. Lee said, during his eighth day at the Roaders Hotel in Taipei, Taiwan. “I was inside my San Francisco apartment for 22 out of 24 hours a day! But it’s a surprisingly intense experience. Those two hours make a big difference.”

Joy Jones, a coach and educator who is based in San Francisco, traveled to New Zealand with her husband, a New Zealand citizen, and two young daughters in January. She learned before their departure that they would have no say where they would be quarantined.

“That was probably the hardest part,” she said. “I could put together a bag of activities for my older daughter, and plan on doing laundry in the sink. But not having an answer to where we’d be — after more than 21 hours of flying, with masks — would we have to get another flight? A three-hour bus ride?” They didn’t. Ms. Jones and her family were taken to Stamford Plaza in Auckland, just 25 minutes from the airport.

The challenge is managing the tedium.

“We decorated a paper horse that we hung in our window — every day, a different part of it — that was a favorite activity. We’d have dance parties. And we’d watch a movie every night. We did what we could to bring some fun into it,” Ms. Jones said.

She documented her family’s quarantine experience on her private Instagram account, showing forts made of blankets, paper airplane competitions and “bowling” with water bottles and a crumpled ball made of paper. She was touched that friends and family sent her family meals, treats and toys in response to her posts.

“It was a really cool way to feel love, and connection, from such an isolated space,” she said.

Dr. Anthony S. Fauci, the president’s chief medical adviser, briefing reporters at the White House last month.
Credit…Doug Mills/The New York Times

The coronavirus pandemic has crippled economies, shut down travel and claimed hundreds of thousands of lives, transforming the world in ways that would have been unthinkable a year ago. The Biden administration’s first days were inevitably dominated by discussion of how his team would tackle the crisis, as the U.S. death toll continued its inexorable climb to a staggering milestone: 500,000 deaths.

Here’s a look at the key figures on President Biden’s Covid-19 response team, and some of their plans to try to stop the spread of the virus and regain some semblance of normalcy.

Dr. Anthony S. Fauci, chief medical adviser. The longtime head of the National Institute of Allergy and Infectious Diseases, Dr. Fauci said he accepted the president’s offer to be his chief medical adviser “right on the spot.” Considered the nation’s leading infectious disease expert, he has been an adviser to every president since Ronald Reagan, and was awarded the Presidential Medal of Freedom by George W. Bush for his work fighting H.I.V./AIDS. But he became a household name only after the start of the pandemic, when he emerged as a trusted authority in countless news briefings, interviews and public appearances.

Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention. Dr. Walensky, previously chief of the division of infectious diseases at Massachusetts General Hospital and a professor at Harvard Medical School, replaced Dr. Robert R. Redfield. She has also focused on H.I.V./AIDS in her career, and has served as chair of the Office of AIDS Research Advisory Council at the National Institutes of Health, and as an adviser to the World Health Organization. Dr. Walensky has pledged to restore public trust in the agency and to provide accurate information “even when the news is bleak, or when the information may not be what those in the administration want to hear.”

Credit…Rich Pedroncelli/Associated Press

Xavier Becerra, nominee for secretary of health and human services. Mr. Becerra was appointed as attorney general of California in 2017, when his predecessor, Kamala Harris, joined the Senate, and he was elected to a full term in 2018. He became known as a lead attacker in the Trump resistance, filing roughly 100 lawsuits against the administration on issues including climate change, gun control and health care. Notably, he led 20 states and the District of Columbia in a campaign to protect the Affordable Care Act. Before serving as attorney general, he spent 24 years in Congress, representing a Los Angeles district. If confirmed, he would be the first Latino to run the mammoth department, which has a budget of more than $1 trillion. He pledged at a Senate confirmation hearing on Tuesday to find “common cause” with his critics, and is scheduled to appear on Wednesday before the Senate Finance Committee.

Dr. Vivek H. Murthy, nominee for surgeon general. Dr. Murthy served as surgeon general under President Barack Obama — he was one of the youngest ever — and is Mr. Biden’s nominee for the same position. He is a physician who has taught at Harvard Medical School and served as vice admiral of the U.S. Public Health Service Commissioned Corps. Dr. Murthy has been outspoken about linking public health and wellness. His book “Together: The Healing Power of Human Connection in a Sometimes Lonely World” was published last year. His confirmation hearing is scheduled to begin Thursday.

Credit…Yale University, via Associated Press

Dr. Marcella Nunez-Smith, chair of the Covid-19 Health Equity Task Force. A physician and public health specialist at Yale University, Dr. Nunez-Smith is leading a team of 12 experts advising the president on how to address the disproportionate impact of Covid-19 on vulnerable communities. Dr. Nunez-Smith grew up in the U.S. Virgin Islands and came from a family of health care providers. She has spoken in interviews about how seeing her father suffer a debilitating stroke in his 40s, caused by untreated high blood pressure, spurred her to work in public health.

Jeffrey D. Zients, coordinator of the administration’s Covid-19 response. Mr. Zients, an entrepreneur and consultant, joined the Obama White House in 2009 and became known as a Mr. Fix-It with strong operational skills. He was tapped to untangle the messy rollout of the Affordable Care Act’s online insurance marketplace in 2013. After Mr. Obama left office, Mr. Zients joined the private equity fund Cranemere as chief executive and also served on Facebook’s board.

Andy Slavitt, senior White House pandemic adviser. Mr. Slavitt, a former health care company executive, served as the acting administrator of the Centers for Medicare and Medicaid Services from 2015 to 2017. (His company was also involved in fixing the A.C.A. website before that.) Mr. Slavitt was outspoken in his defense of the Affordable Care Act during the Trump administration — and raised the alarm about the pandemic early in 2020. He’s active on Twitter, writes on Medium, and till not too long ago, hosted a podcast about Covid. He has said that he accepted the White Home job “on a short-term foundation.”

Dr. David Kessler, chief science officer for the Covid-19 response. Dr. Kessler, a pediatrician and lawyer who was head of the Meals and Drug Administration in the course of the presidencies of George Bush and Invoice Clinton, will oversee the vaccine program. He’ll share obligations with Gen. Gustave F. Perna, who was the chief working officer for Operation Warp Pace, the Trump administration’s program to speed up vaccines and coverings. (The Biden administration later dropped that identify.) As F.D.A. commissioner, Dr. Kessler was recognized for battling the tobacco trade and creating vitamin truth labels on meals merchandise. Dr. Kessler is near Dr. Fauci; the 2 labored collectively to hurry the event and approval of medicine that modified the course of the AIDS epidemic within the Nineties.

Dr. Janet Woodcock, appearing commissioner, Meals and Drug Administration. Dr. Woodcock was the longtime head of the F.D.A.’s Heart for Drug Analysis and Evaluation, and labored on Operation Warp Pace. The Biden administration has not but nominated a everlasting commissioner; Dr. Woodcock and Dr. Joshua Sharfstein, a former high-ranking F.D.A. official, are the obvious front-runners.

A shipment of Covid-19 vaccines donated by the Indian government, arrived in Kabul, Afghanistan, this month.
Credit score…Wakil Kohsar/Agence France-Presse — Getty Pictures

Afghanistan, whose residents have largely brushed apart the coronavirus pandemic as exaggerated or an outright hoax, is now making ready to distribute its first batch of vaccines.

A half-million doses of the AstraZeneca-Oxford vaccine, produced by an Indian producer, had been delivered to the capital, Kabul, on Feb. 7. However the arrival was greeted with indifference by many Afghans, who’ve rebuffed authorities warnings that the virus is a lethal public well being menace.

A budget and easy-to-store AstraZeneca-Oxford vaccine is being delivered as a part of the Covax program, a worldwide initiative to purchase and distribute vaccines to poor international locations at no cost or at a decreased value. On Feb. 15, the World Well being Group approved use of the vaccine, which requires two doses per particular person, clearing the trail for Afghanistan to start its inoculation marketing campaign.

World trials have discovered that the vaccine supplied full safety in opposition to extreme illness and loss of life. However its efficacy in opposition to the virus variant first recognized in South Africa is in query, after the shot failed in a small trial to forestall research individuals from getting gentle or average sickness.

The vaccine arrives as Afghanistan is combating off a second lethal wave, whilst most Afghans go about their every day lives as if the virus by no means existed. Many individuals refuse to put on masks and cluster in dense crowds inside bazaars, supermarkets, eating places and mosques, oblivious to ubiquitous public well being posters.

In an impoverished nation battered by conflict, starvation, poverty and drought, an invisible virus is taken into account pretend — or an afterthought.

“After all I gained’t take the vaccine as a result of I don’t imagine within the existence of the coronavirus,” mentioned Muhibullah Armani, 30, a taxi driver within the southern metropolis of Kandahar.

Expressing a sentiment shared by many Afghans, Mr. Armani added, “Once I see individuals overlaying their mouth and nostril, afraid of Covid, it makes me snort at them.”

Students wait at distanced intervals as they arrive for school in New York in September. For teenagers in a mental health crisis, there aren’t many places to turn.
Credit score…John Minchillo/Related Press

For youngsters and younger adults who’re anxious by nature or feeling emotionally fragile, the pandemic and its social isolation have pushed them to the brink.

Charges of suicidal considering and habits are up 25 % or extra from comparable intervals in 2019, based on an evaluation of surveys of younger sufferers in emergency rooms.

For the younger individuals coming undone, pandemic life presents uncommon challenges, pediatricians say. Most are temperamentally delicate and after months of being socially lower off from buddies and actions, and so they have a lot much less management over their moods.

“What mother and father and youngsters are constantly reporting is a rise in all signs — a baby who was somewhat anxious earlier than the pandemic turned very anxious over this previous yr,” mentioned Dr. Adiaha I. A. Spinks-Franklin, an affiliate professor of pediatrics on the Baylor Faculty of Medication. It’s this extended stress, Dr. Spinks-Franklin mentioned, that in time blunts the mind’s capacity to handle feelings.

For youngsters in a psychological well being disaster, there aren’t many locations to show. They need assistance, however it’s onerous to give you a psychiatric prognosis. They’re making an attempt to handle a shock interruption of their lives, a imprecise loss. And with no prognosis, reimbursement for remedy is tough to come back by. And that’s assuming mother and father know what sort of assist is acceptable, and the place to search out it.

When a disaster does hit, many of those youngsters find yourself within the native emergency division — the one place determined households so usually go to for assist.

Many E.R. departments throughout the nation are actually seeing a surge in such instances. Via most of 2020, the proportion of pediatric emergency admissions for psychological issues, like panic and anxiousness, was up by 24 % for younger kids and 31 % for adolescents in comparison with the earlier yr, based on a latest report by the Facilities for Illness Management and Prevention.

The native emergency division is regularly unprepared for the added burden. Staff usually should not specifically skilled to handle behavioral issues, and households don’t have many choices for the place to go subsequent, leaving many of those pandemic-insecure adolescents in limbo on the E.R.

“It is a nationwide disaster we’re going through,” Dr. Rebecca Baum, a developmental pediatrician in Asheville, N.C. “Children are having to board within the E.R. for days on finish, as a result of there aren’t any psychiatric beds obtainable of their total state, by no means thoughts the hospital. And naturally, the kid or adolescent is mendacity there and doesn’t perceive what’s taking place within the E.R., why they’re having to attend there or the place they’re going.”

world roundup

Preparing to offload a refrigerated container carrying Thailand’s first delivery of Covid-19 vaccines at Suvarnabhumi Airport in Bangkok on Wednesday.
Credit score…Adam Dean for The New York Occasions

Thailand, which has lagged behind a few of its Southeast Asian neighbors in acquiring coronavirus vaccines, acquired its first cargo Wednesday: 200,000 doses of the CoronaVac shot from China.

Prime Minister Prayuth Chan-ocha and most of his cupboard had been available at Suvarnabhumi Worldwide Airport outdoors Bangkok to greet the arrival of a Thai Airways cargo aircraft delivering the doses. The CoronaVac shot was developed by a personal Chinese language firm, Sinovac Biotech, and has confronted scrutiny over an absence of information from late-stage medical trials.

The Thai officers stood in entrance of a banner proclaiming: “Covid-19 Vaccine: Returning Smiles to Thailand.” The nation has lengthy promoted itself as a vacationer vacation spot with the slogan “The Land of Smiles.”

Thailand’s Meals and Drug Administration authorized Sinovac’s vaccine for emergency use on Tuesday. Sinovac is anticipated to ship two million doses in complete, with well being staff receiving the primary inoculations.

Up to now, just a few governments in Asia have authorized CoronaVac to be used. A number of extra have mentioned they’d solely achieve this after receiving full trial knowledge from the producer.

In an announcement earlier than the CoronaVac cargo arrived, Mr. Prayuth mentioned that 65 million doses of vaccines had been deliberate up to now, and that vaccines from different producers would arrive quickly. Thailand authorized the AstraZeneca vaccine in late January.

Vietnam, which has additionally been comparatively profitable in containing the virus however sluggish to acquire vaccines, acquired its first cargo Wednesday: 117,000 doses of the AstraZeneca-Oxford vaccine.

Thailand has been among the many most profitable international locations in containing the virus, with fewer than 26,000 instances and 83 deaths because the begin of the pandemic. Greater than 80 % of the instances have been recorded since December, when the nation skilled its most severe outbreak at a seafood market in Samut Sakhon Province. Since then, the variety of new instances has fallen to beneath 100 a day and the federal government has been step by step easing restrictions.

Thailand’s vaccination plan has been much less formidable than its program of contact tracing and containment. The federal government has referred to as for inoculating half the nation of roughly 70 million individuals by the tip of the yr.

In distinction to Thailand’s sluggish begin, Singapore started vaccinations in late December, Indonesia began six weeks in the past, and Myanmar practically a month in the past, though its program has been disrupted by the Feb. 1 army coup.

Thailand’s tourism sector, which accounts for about 20 % of the economic system, has pushed for a extra aggressive vaccination program to assist reopen the nation to international guests.

Because the starting of the outbreak, Thailand has required practically everybody arriving from abroad to bear quarantine for 14 days. Mr. Prayuth mentioned on Wednesday that the federal government was contemplating whether or not to permit foreigners who’ve been vaccinated to skip quarantine.

In different worldwide information:

  • Taiwan mentioned on Wednesday that it will resume permitting short-term enterprise vacationers from sure “low-risk” international locations to use to isolate for lower than the same old two weeks upon arrival — an exemption that it canceled two months in the past amid considerations concerning the pandemic’s severity. The self-governing island remains to be closed to vacationers and most different nonresidents.

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