PARIS — More than a year after the government in France ordered its first national lockdown to fight back the Covid-19 pandemic, the authorities now seem to have little choice but to do the same again, as infections rise sharply across the country and hospitals in Paris are overflowing.
President Emmanuel Macron will address the country at 8 p.m. on Wednesday and is expected to announce new restrictions, possibly bringing in a third national lockdown, which he has long tried to avoid.
France on Tuesday reported more than 5,000 people in intensive care units for the first time since last April, with bed shortages in hospitals in the most affected areas becoming acute. And the slow vaccine rollout has not prevented an outburst of infections, as an average of about 37,000 daily new cases have been reported over the past week.
“The outlook is worse than frightening,” Jean-Michel Constantin, the head of the intensive care unit at the Pitié-Salpêtrière hospital in Paris, told RMC radio on Monday.
“We’re already at the level of the second wave and we’re quickly getting close to the threshold of the first wave,” he said. “April is going to be dreadful.”
New restrictions were introduced on the regional level in mid-March in an attempt to stave off a third wave of infections, affecting about a third of the population, including the Paris region. The rules forced businesses that are considered nonessential to close, ordered residents to limit their outdoor activities to places within six miles of their homes and banned travel to or from regions where infections were rising.
But as infections nonetheless stubbornly rose, pressure has been building on Mr. Macron to implement tougher measures.
Writing in Le Journal du Dimanche, 41 doctors from the Paris region warned that hospitals may soon become so stretched that they will have to choose which patients to try to save.
“All indicators show that the current measures are and will be insufficient to quickly reverse the alarming curve of contaminations,” they wrote.
Mr. Macron, in the same newspaper, said that he would “look at the effectiveness of the containment measures in the coming days, and we’ll take others if they are necessary.”
In late January, Mr. Macron made a calculated gamble of resisting a new national lockdown, hoping that his government could tighten restrictions just enough to fight back a rise in infections.
That strategy seemed to be working until mid-March, when infections rose sharply and the vaccination campaign failed to gather speed, amid the disarray of the rollout of the AstraZeneca vaccine.
Many doctors and epidemiologists are calling for a lockdown comparable to that of early 2020, when the authorities enforced some of the strictest Covid-19 restrictions in Europe, ordering people to stay inside except for a few exceptions. Schools, which France has kept open since last June, unlike many of its neighbors, could also be forced to close as the virus is increasingly spreading in classrooms.
Even as much of the rest of the country has had a reprieve, New York City has remained a coronavirus hot spot, with new cases holding level, often at about 25,000 a week.
As variants and vaccinations have taken hold, public health experts have debated what to call the current, confusing phase of the epidemic, when cases remain alarmingly high, but hope is drawing nearer.
“The term I’ve been using is ‘high plateau’,” said Dr. Jay Varma, a senior adviser for public health at City Hall. “We’re basically trying to come down off of our second wave and what we’re trying desperately to do is prevent a third wave.”
Since mid-February, the seven-day average of new cases in the city has largely remained between 3,500 and 4,000.
Epidemiologists and disease modelers spoke of a stalemate between the pace of vaccinations and the momentum of two new, more contagious variants that were spreading steadily across the city. Those variants now make up a majority of cases, city officials said.
Several public health experts who use prediction models believe that New York’s current upswing probably won’t reach levels that the city saw during the peak after the holiday season, when cases surged to nearly 6,500 per day on average. But the cases aren’t likely to drop much soon either.
Dr. Ronald Scott Braithwaite, a professor at N.Y.U. Grossman School of Medicine who has been modeling New York City’s epidemic and is an adviser to the city, predicted that cases would gradually rise — “not so much a wave, but a bulge,” he said — for a month or two until a critical number of people had been vaccinated.
“At our current rate of vaccination, it seems it will be mid- to late May before vaccinations win the tug of war,” Dr. Braithwaite said.
On Monday, state officials announced that all adults in New York would be eligible for vaccination starting next week, which should boost the vaccination effort as supply begins to increase.
The new normal for New York City, at least until mid-May, may well be an average positive test rate that hovers around 6 percent and a daily case rate of around 4,000.
Wan Yang, a professor of epidemiology at Columbia University’s Mailman School of Public Health, said that changing social behavior might be the tipping point that leads to a sustained upswing in cases. She noted that New York’s restrictions had eased over the past month — including looser limits around indoor dining and the reopening of indoor fitness classes — and that many New Yorkers were socializing and interacting more than before.
Tracey Tully contributed reporting.
LONDON — The British government said in February that everyone living in the country would be eligible for a coronavirus vaccine, free of charge, regardless of their immigration status. But many undocumented immigrants in the country are not getting inoculated.
Some are afraid that asking for a shot will get them deported. Others have been turned away at local doctors’ offices, which often ask for identification or proof of address, even though neither is required to access primary care in Britain. And many simply are in the dark about the services available to them — a lasting effect of a government policy of hobbling their access to jobs, bank accounts and free medical care in the hope of spurring them to leave the country.
“It’s all very well to say, ‘Anyone can get a vaccine,’” said Phil Murwill, head of services at Doctors of the World U.K, a humanitarian organization. “But for years, there was a deliberate policy of creating a hostile environment for undocumented immigrants that has put people off from accessing any kind of care. And we’re seeing that play out now.”
As in much of the world, the virus has ravaged immigrant communities in Britain, which supply the bulk of frontline workers in grocery stores and domestic care. The British government has not published a count of its undocumented immigrant population since 2005, but outside estimates put the number at 800,000 to 1.2 million. It is a significant group that includes many at-risk workers, and one that epidemiologists say the nation’s vaccination effort must reach if Britain hopes to safely exit the pandemic.
In the United States, efforts are underway to prioritize vaccinating those in jobs done primarily by undocumented immigrants, like farm work. But Britain did not extend its “social care” eligibility category to include domestic workers, a Department of Health and Social Care spokesperson confirmed in an email.
The department has said that anyone undergoing vaccination, testing or treatment for the coronavirus would not be subject to immigration status checks. But there are still instances in which the department shares patient information with the Home Office, which is in charge of immigration. Most commonly, it occurs when undocumented immigrants have overdue secondary-care medical bills of 500 pounds, about $690, or more. (Primary care is free.)
“The government needs to suspend all charging and data-sharing operations, if they want to prioritize the widest possible access to public health,” said Zoe Gardner, a policy adviser for the Joint Council for the Welfare of Immigrants.
What does it take to get a vaccine in Ukraine? For some people, lots of Facebook friends.
Ukraine’s vaccine effort, which has been among the slowest in Europe, has been hampered by widespread hesitancy, mainly among older people who currently qualify for the shot. The problems have not been helped by the flood of often confusing and bad news around the AstraZeneca vaccine, the main option available in the country. Recent opinion polls have shown that about 40 percent of Ukrainians do not trust the shot.
To bolster acceptance, the Ministry of Health has opened vaccination to people deemed to have a public persona, regardless of their age. That includes actors, pop stars, athletes, writers, journalists — and social media influencers.
The criteria are decided locally, by city officials or doctors at vaccination sites. Those who think they have sway with the public can fill out an online form, which asks how many social media followers they have, on Facebook or on other platforms. Influencers only qualify for shots leftover at the end of the day that might otherwise be wasted.
The main requirement under the program is that recipients share their vaccination selfies on social media.
The program has drawn some bona fide opinion leaders. The Ministry of Health organized a public vaccination of leaders of different religions, for example. “The Lord sent us vaccinations,” the chief rabbi of Kyiv, Jonathan Markovitch, said, encouraging inoculation. “You definitely need to take advantage of this.”
The program was quickly flooded with young influencers. There they were, in glowing good health and at relatively little risk from the disease, posting pictures of themselves getting the shot, grinning or giving a thumbs up.
Some had fewer than a thousand followers on social media. Medical ethicists say that anybody offered a shot should take it, even if they think others may be more qualified. The recipients do not set the rules, after all, and refusing a shot can risk vaccine being wasted.
In the month since Ukraine received its first shipment of 500,000 doses, fewer than half have been administered. The country is going through a new wave of infection, registering this month the highest numbers of new cases and deaths since the beginning of the pandemic.
Still, the ministry published a revised rule this month limiting the program to influencers older than 60, though few could be found.
China on Wednesday sought to shift attention away from efforts inside its borders to trace the source of the coronavirus, arguing that health experts should start looking for clues in other countries.
A day after the World Health Organization released a report detailing the findings from a team of experts that visited the city of Wuhan, Chinese state media outlets rejected criticism from the White House and others that Beijing had not been transparent in the inquiry.
“Maybe it’s time for scientists to dig somewhere else and test more hypotheses to solve the mystery,” said an article in Global Times, a nationalistic tabloid owned by China’s ruling Communist Party.
The Chinese foreign ministry echoed that sentiment, saying in a statement that the investigation into the origins of the virus was a “global mission that should be conducted in multiple countries and localities.”
The remarks by Chinese officials clash with the prevailing view among scientists that the virus most likely emerged in China and that resources should be focused on further studies inside the country.
The 124-page W.H.O. report, written jointly by a team of 17 Chinese scientists and 17 global experts, concluded that the coronavirus probably emerged in bats before spreading to humans through an intermediate animal. But it said that China lacks the research to indicate how or when the virus began spreading, and recommended more detailed studies of the earliest infections and extensive testing of livestock and farmers in China and Southeast Asia.
Whether Beijing will cooperate in further investigation is unclear. As Chinese news outlets used the W.H.O. report to praise the government, they largely ignored critical comments on Tuesday by Dr. Tedros Adhanom Ghebreyesus, the W.H.O. chief, who acknowledged concerns about China’s refusal to share raw data about early Covid-19 cases.
There was also little coverage of Dr. Tedros’s suggestion that experts should look more closely at the possibility that the virus emerged accidentally from a Chinese lab. Chinese officials have repeatedly sought to discredit that theory.
Albee Zhang contributed research.
SANTIAGO, Chile — Having negotiated early access to tens of millions of doses of Covid-19 vaccines, Chile has been inoculating its residents faster than any other country in the Americas and appears poised to be among the first in the world to reach herd immunity.
But experts say the country’s speedy and efficient vaccination drive — only Israel, the United Arab Emirates and Seychelles have vaccinated a larger share of their populations — gave Chileans a more lax outlook toward the virus, contributing to a sharp spike in new infections and deaths.
The surge in cases, even as more than a third of Chile’s population has received at least the first dose of a Covid-19 vaccine, serves as a cautionary tale for other nations looking to vaccination drives to quickly put an end to the era of beleaguered economies, closed borders and social distancing. The rise in cases prompted a new set of strict lockdown measures that have restricted mobility for much of the country, affecting nearly 14 million people.
The severity of the crisis became clear on Sunday, as President Sebastián Piñera asked Congress to delay by six weeks a vote scheduled for early April to elect the representatives who will draft a new constitution and other officials. In a statement, Mr. Piñera argued that the current state of the pandemic was not conducive to holding a vote that was “democratic, inclusive and safe.”
While more than six million of the country’s 18 million people have been vaccinated, a surge in infections has left intensive care units operating with few beds to spare and the system at a breaking point.
Last week Chile recorded 7,626 new Covid-19 cases in a single day, a record, and the pace of new infections has doubled in the past month. Officials have also identified cases of new variants that were first seen in Britain and Brazil.
“No one questions that the vaccination campaign is a success story,” said Dr. Francisca Crispi, a regional president of Chile’s medical association. “But it conveyed a false sense of security to people, who felt that since we’re all being vaccinated the pandemic is over.”
Pascale Bonnefoy and
Every day for a year, Kathy James peered through the window at her mother’s assisted living facility outside Chicago and dreamed of the day they would be together again.
That moment finally came one recent morning, when Ms. James packed a goody bag full of family photographs, a Sunday copy of The Chicago Tribune and a container of potato soup, and met her mother, Renee Koerber, 90, inside the nursing home.
“I said, ‘Mom, we’re in the same room!’” said Ms. James, 63, her heart swelling with relief.
They had made it.
But sitting several feet apart in a common area, where they were not allowed to hug, Ms. James was also startled at how frail her mother looked. She seemed to grow tired after just 15 minutes. “I thought I would be so happy,” Ms. James said. “And I just feel such grief because of the year of time I have lost and I will never get back.”
Many American nursing homes have begun to welcome visitors again after a year of excruciating lockdowns. The Biden administration in March published sweeping guidelines allowing indoor visits in most cases. It is a profound change that comes as vaccinations ramp up, reaching nearly 100 million Americans, including a majority of people in nursing homes.
Even as the head of the Centers for Disease Control and Prevention warned this week of a possible fourth coronavirus surge, nursing homes are so far holding steady, reporting drastically fewer cases and deaths since the start of vaccinations. The improved outlook means that across the country, people are once again greeting loved ones in nursing homes with bouquets of flowers, with homemade pudding and lemon bars, with news from children and grandchildren.
Nursing homes have been centers of the pandemic since the beginning, when an outbreak was first identified at a facility outside Seattle. In the United States, the pandemic has killed more than 179,000 residents and employees of long-term care facilities — one-third of all coronavirus deaths nationwide — and left many others withering in isolation.
In reopening to visitors, nursing homes now offer an early glimpse at what everyone may face in trying to go back to normal after a year of separation and stillness. Some reunions may be tinged with grief, others with reminders of all that has changed.
Pauline Boss, a family therapist and professor emeritus at the University of Minnesota, said the experiences of families coming back together reminded her of research she had done on husbands returning home to wives after war, or cancer patients who suddenly learn they are in remission.
“Things don’t quite get back to normal,” Dr. Boss said.
