As a second wave of the pandemic rages in India, which logged more than 300,000 new coronavirus cases for the sixth consecutive day on Tuesday, countries around the world are trying to help. But their efforts to send oxygen and other critical aid are unlikely to plug enough holes in India’s sinking health care system to end its deadly catastrophe.
The Indian health ministry reported more than 320,000 new cases and 2,771 deaths on Tuesday. Both figures represented slight declines from the previous day’s record highs, but experts said this was not a sign that the outbreak was easing. With enormous funeral pyres spilling into parking lots and city parks, there are signs that India’s reported overall toll of nearly 198,000 deaths could be a vast undercount.
The Australian government said on Tuesday that it would halt commercial flights from India until at least May 15, joining Britain, Canada, Singapore and several other nations that have restricted travel from the country. Australia’s prime minister, Scott Morrison, said his government would donate ventilators and protective equipment to help India contain the outbreak.
The emergency in India, where a worrying virus variant is spreading rapidly, is driving a new global surge in the pandemic. It also carries implications for countries relying on India for the AstraZeneca vaccine, millions of doses of which are manufactured there.
“It’s a desperate situation out there,” said Ramanan Laxminarayan, the founder and director of the Center for Disease Dynamics, Economics & Policy, adding that donations would be welcome but might make only a “dent on the problem.”
Scientists fear that part of the problem is the emergence of a virus variant known as the “double mutant,” B.1.617, because it contains genetic mutations found in two other difficult-to-control versions of the coronavirus. One of the mutations is present in the highly contagious variant that ripped through California earlier this year. The other is similar to one found in the variant dominant in South Africa and is believed to make the virus more resistant to vaccines.
Still, scientists caution that it is too early to know with certainty how pernicious the variant emerging in India is.
Earlier this year, the government of Prime Minister Narendra Modi acted as if the coronavirus battle had been won, holding huge campaign rallies and permitting thousands to gather for a Hindu religious festival.
Now, Mr. Modi is striking a far more sober tone. He said in a nationwide radio address on Sunday that India has been “shaken” by a “storm.” And countries, companies and powerful members of the diaspora have pledged to pitch in.
Patients are suffocating in the capital, New Delhi, and other cities because hospitals’ oxygen supplies have run out. Frantic relatives have appealed on social media for leads on intensive-care-unit beds and experimental drugs. The government has extended New Delhi’s lockdown by another week.
India’s Supreme Court last week ordered the government to come up with a “national plan” for distributing oxygen supplies.
Mr. Modi appears to be looking to the rest of the world to help India quell the wave. Britain, Germany, France, Saudi Arabia and the United Arab Emirates have promised oxygen generators or ventilators. The United States has pledged raw material for coronavirus vaccines and intends to share up to 60 million doses of the AstraZeneca vaccine with other nations, so long as the doses clear a safety review conducted by the Food and Drug Administration, officials said Monday. Indian-American businessmen have pledged millions in cash from the companies they lead.
At a news conference on Monday, Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, called the situation in India “beyond heartbreaking.” He said the organization had deployed 2,600 staff members to India to provide vaccination help.
The world’s seven-day average of new cases has remained well above 750,000 for the past week, according to a New York Times database, higher than the peak average during the last global surge in January. Despite more than one billion shots having been administered globally, far too small a percentage of the world’s nearly eight billion people has been vaccinated to slow the virus’s spread.
President Biden and top U.S. health officials are expected on Tuesday to announce new recommendations for fully vaccinated individuals, including a possible easing of mask restrictions outdoors.
Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said on NBC News last week that the agency was “looking at” whether it’s still necessary to wear a mask outdoors. And on Sunday, Dr. Anthony S. Fauci, the nation’s top infectious disease specialist, said that the federal health agency might move toward loosening mask requirements.
He characterized the risk of infection to a vaccinated individual outdoors as “minuscule.”
“I think it’s pretty common sense now that outdoor risk is really, really quite low,” for a vaccinated people, Dr. Fauci said on the ABC News program “This Week.”
Several states have already dropped mask mandates and fully reopened indoor and outdoor venues, even for large sporting events. New York still has mask requirements.
A growing body of research indicates that the risk of spreading the virus is far lower outdoors than indoors. Viral particles disperse quickly outdoors, experts say, meaning brief encounters with a passing walker or jogger pose very little risk of transmission.
“That biker who whizzes by without a mask poses no danger to us, at least from a respiratory virus perspective,” Dr. Paul Sax, an infectious disease specialist at Brigham and Women’s Hospital, wrote in a blog post for The New England Journal of Medicine.
A recent systematic review of studies that examined the transmission of the coronavirus and other respiratory viruses among unvaccinated individuals concluded that fewer than 10 percent of infections occurred outdoors and that the odds for indoor transmission were 18.7 times higher than outdoors. (The odds of superspreading events were 33 times higher indoors.)
But the paper’s author said that the low odds of transmission outdoors could simply reflect the fact that people had spent little time outside. In cases where transmissions occurred outdoors, there was often also prolonged or frequent contact with another individual or a group of people, or an indoor component to an outdoor gathering, said Dr. Nooshin Razani, an associate professor of epidemiology and biostatistics at the University of California, San Francisco.
“It does happen: You can get infected outdoors,” she said. “It usually has to do with how long you’re with someone and how often you see them, and if you’re wearing a mask and if you’re close to each other.”
The C.D.C. currently recommends that vaccinated people should wear masks and maintain six feet of distance from others in public, including while taking public transportation such as buses, trains or planes and while in transportation hubs. It also recommends they continue to avoid crowds, large gatherings and poorly ventilated spaces.
Brazil’s health authority, Anvisa, said late on Monday that it would not recommend importing Sputnik V, the Covid-19 vaccine developed by Russia.
The need for vaccines is urgent in Brazil: It has been battered by one of the world’s worst outbreaks, driven by the highly contagious P.1 virus variant.
But Anvisa said that questions remained about the vaccine’s development, safety and manufacturing.
Data about the vaccine’s efficacy were “uncertain,” Gustavo Mendes Lima Santos, Anvisa’s manager of medicine and biological products, said in a lengthy presentation explaining the health authority’s decision. The presentation said that there were “crucial questions” that had gone unanswered, including about potential adverse events such as clotting.
The official Sputnik V Twitter account pushed back on Monday in a series of tweets in Portuguese, saying that the vaccine’s developers had shared “all the necessary information and documentation” with Anvisa. In another tweet, it said Anvisa’s decision “was of a political nature” and had “nothing to do with access to information or science.” It alleged that the United States had persuaded Brazil to deny approval.
Russia is using Sputnik V in its mass vaccination campaign, and the vaccine has been approved for emergency use in dozens of other countries. Its rollout has been entangled in politics and propaganda, with President Vladimir V. Putin announcing its approval for use even before late-stage trials began.
The Gamaleya Research Institute, part of Russia’s Ministry of Health, developed the vaccine, also known as Gam-Covid-Vac. A peer-reviewed study published in The Lancet in February said the vaccine had an efficacy rate of 91.6 percent.
Skepticism from Western experts has focused mostly on its early approval, not the vaccine’s design, which grew out of decades of research on adenovirus-based vaccines. Other Covid-19 vaccines are also based on adenoviruses, such as one from Johnson & Johnson, using Ad26, and one by AstraZeneca.
While Sputnik V’s developers have yet to release detailed data on adverse events observed during the trials, the Russian government has been using the vaccine to inoculate its own citizens for months. Russia has also exported Sputnik V to Belarus, Argentina and other countries, suggesting that any harmful side effects overlooked during trials would by now have come to light.
As vaccine supply woes in Europe worsened, the European Union’s drug regulator announced last month that it was reviewing the Sputnik V vaccine.
Greece lifted quarantine requirements on Monday for arrivals from seven more countries, including Russia and Australia, continuing an easing of rules for foreign visitors before a formal reopening to tourists on May 15.
Last week, Greece ended quarantine restrictions for visitors from European Union member states as well as the United States, Britain, Serbia and the United Arab Emirates. The steps were similar to those put in place in March for arrivals from Israel, which has been far ahead of most of the world in vaccinations.
Greece is also stopping restrictions this week for visitors from New Zealand, South Korea, Thailand, Rwanda and Singapore.
Greece had previously required arrivals to quarantine themselves for seven days. It is waiving that rule for passengers from the listed countries as long as they produce a vaccination certificate or the results of a negative PCR test conducted within 72 hours of their arrival.
After heavy economic losses in 2020, the Greek authorities are determined to save this year’s summer tourist season despite experiencing a severe third wave of coronavirus infections. Health officials have said the infection rate is stabilizing, though slowly. Greek health officials have reported more than 334,000 infections and more than 10,000 deaths from the virus, according to a New York Times database.
A new concern is the appearance of the coronavirus variant that is believed to be fueling the worsening outbreak in India. On Sunday, health officials recorded the second case of that variant in Greece, found in a 33-year-old foreign woman who had traveled to Dubai in early April.
Greece’s high infection rate remains a worry for some governments. The U.S. State Department has advised against travel to Greece, citing a “very high level” of coronavirus cases. Greek health officials have expanded testing in recent weeks as they gradually lift lockdown restrictions, with bars and restaurants scheduled to reopen on May 3 after a six-month hiatus.
With Thailand struggling to bring its worst coronavirus outbreak under control, Bangkok made it compulsory for residents to wear masks in public beginning on Monday. One of the first to break the new rule?
The country’s prime minister, Prayuth Chan-ocha, who was seen maskless at a government meeting in a photo published on his official Facebook page.
As a first-time offender, he agreed to pay a fine of about $190. Bangkok’s governor, Aswin Kwanmuang, came around with top police officials on Monday to help collect it.
“I informed the prime minister this was a violation of the rules,” the governor wrote on Facebook. The photograph was removed from the prime minister’s Facebook page.
For Mr. Prayuth, the gaffe is the least of his pandemic problems. His government has struggled to curb transmissions and slow to obtain vaccines. As infections ticked upward earlier this month, he decided to let Thais continue to travel widely during a major holiday.
“Whatever will be will be,” he said then. “The government will have to try to cope with that later.”
Now, his government is scrambling to procure vaccines from a stretched global supply and rushing to set up field hospitals at sports stadiums and other locations as many hospitals report being near capacity. Only 0.3 percent of the population has been fully vaccinated, according to a New York Times database.
On Tuesday, the government reported 15 deaths, its highest daily total since the pandemic began, and more than 2,000 new cases for the fifth day in a row. That brings Thailand’s total for the pandemic to nearly 60,000 cases and 163 deaths, according to the government.
The numbers are low by global standards; Thailand was among the world’s leaders in containing the virus last year. Nearly 90 percent of its cases have come since Jan. 1.
Many provinces have imposed their own restrictions, including Bangkok, which has ordered the closure of more than 30 types of businesses, such as fitness centers, cinemas, bars and massage parlors. Restaurants, malls and department stores can continue operating but with restrictions.
Nearly two-thirds of Thailand’s provinces have imposed fines for failing to wear a mask in public. The maximum penalty is about $635.
