The coronavirus might be receding in much of the United States, but it continues to spread in communities with low Covid-19 vaccination rates, where highly contagious virus variants pose a threat to those who have not had shots.
In Smith County, Tenn., where only 20 percent of people are fully vaccinated, there has been an almost 700 percent increase in hospitalizations for Covid-19 over the past two weeks, according to a New York Times database. In Trousdale, Tenn., where only 23 percent of people have had two vaccine doses, hospitalizations have also surged by 700 percent in the same period.
The increase is not a coincidence, said Dr. Ted Delbridge, executive director of the Maryland Institute for Emergency Medical Services Systems. People who become ill with Covid-19 now are, “in most age groups, twice as likely to end up hospitalized as people who got the virus earlier in the course of the pandemic,” Dr. Delbridge said.
In Maryland, of those between the ages of 50 and 59 who contracted Covid-19 over the winter, about 8 percent were hospitalized, he said. From the end of April through the beginning of June, the hospitalization rate in that group was 19 percent.
Dangerous virus variants are likely to be to blame, Dr. Delbridge said. The variant first found in Britain, now known as Alpha, is deadlier and more contagious than most others and is now dominant in the United States. Last month, Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said the variant, also known as B.1.1.7, made up 72 percent of U.S. cases at the time.
But vaccines have proven to be effective against the Alpha variant. A spring surge that scientists had warned of largely failed to materialize in the United States.
“I think we got lucky, to be honest,” Nathan Grubaugh, an epidemiologist at Yale University, told The New York Times last month. “We’re being rescued by the vaccine.”
Through Tuesday, about 172 million Americans had received at least one dose of a Covid-19 vaccine, according to a Times database. But vaccine distribution across the country has slowed in recent weeks. About 1 million shots are being administered nationwide each day, down from an April peak of 3 million.
In Michigan, one of the few states that saw a surge in cases this spring, Alpha struck younger people who were returning to schools and playing contact sports.
“Because it’s more transmissible, the virus finds cracks in behavior that normally wouldn’t have been as much of a problem,” said Emily Martin, an epidemiologist at the University of Michigan.
At a White House press briefing on Tuesday, Dr. Anthony Fauci, President Biden’s chief Covid adviser, said the Delta variant, which was originally identified in India, was emerging as the dominant variant in Britain.
“We cannot let that happen in the United States,” Dr. Fauci said, adding that the Delta variant now accounted for 6 percent of sequenced cases in the United States.
Dr. Fauci urged young people to get vaccinated, citing a study that found that two doses of the Pfizer-BioNTech vaccine or the AstraZeneca vaccine appeared to be effective against the Delta variant.
One way of limiting the spread is for those who are vaccinated to wear masks around those who are not, doctors say. At least one state is making that a rule in some places: When California reopens next week, fully vaccinated colleagues working in a room together will be allowed to work maskless. But if one person is unvaccinated, everyone in the room will need to wear a mask.
“If I’m in close proximity to other people, and I don’t know their vaccination status, I put a mask on,” Dr. Delbridge said. “It’s just too easy.”
Cruise lines are starting to make plans to sail this summer out of Florida, which one company called “the cruise capital of the world.” But the state’s ban on vaccine passports complicates how ships can navigate its ports.
Some cruise lines, such as Norwegian Cruise Line, plan to sail with fully vaccinated crews and ensure that guests are also fully vaccinated. But while the federal government says employers can make on-site employees get vaccinated, a Florida state law prohibits businesses from requiring a vaccine passport, or proof of Covid-19 vaccination, in exchange for services.
The law has local officials concerned that their cities lose out if cruise lines decide to skip Florida ports, as Frank Del Rio, chief executive of Norwegian Cruise Line, recently threatened to do as a last resort.
On Monday, the company announced that it planned to set sail this summer from New York, Los Angeles and two Florida cities, Port Canaveral and Miami. The cruise line, however, did not specify how it planned to sail out of Florida.
Mr. Del Rio said the company was in contact with Gov. Ron DeSantis’s staff and legal team to “ensure that we can offer the safest cruise experience for our passengers departing from the cruise capital of the world.”
Other cruise lines, such as Royal Caribbean International, might bow to the state’s vaccine passport ban. Announcing its voyage plans out of Miami this summer, the cruise line said that its crews would be fully vaccinated, while guests were “strongly recommended to set sail fully vaccinated, if they are eligible.”
Royal Caribbean guests who are not vaccinated — or unable to prove that they are — will have to be tested for the virus, and could be subject to other protocols to be announced later, the cruise line said.
Last week, the mayors of Broward County, Fort Lauderdale and Hollywood sent a letter to Governor DeSantis urging him to reconsider the state’s position on vaccine passports. They argued that the cruise lines “are ready to set sail” based on U.S. Centers for Disease Control guidelines, but that the ban on vaccine passports prevented them from doing so.
“We are extremely concerned that unless a resolution can be reached, this impasse over the rules will result in the loss of the cruise industry in Broward County and Florida overall,” the mayors wrote.
Coronavirus cases are surging in Mongolia, where more than half the population is fully vaccinated, prompting a new focus on the effectiveness of its main vaccine, developed by China’s Sinopharm.
Mongolia reported 1,312 new cases of the coronavirus on Wednesday as the country’s total infections neared 70,000, almost all recorded since January. New daily infections have risen more than 70 percent in the past two weeks, according to a New York Times database.
The landlocked nation has emerged as an outlier in the global scramble for vaccines among developing nations, securing enough doses for its eligible population thanks to its strategic location between Russia and China — two vaccine manufacturing giants with global ambitions. Mongolia has signed deals for 4.3 million doses of the Sinopharm vaccine and one million doses of Russia’s Sputnik V vaccine, although only 60,000 Sputnik doses have arrived so far.
Chinese vaccines, such as the ones made by Sinopharm and another company, Sinovac, use inactivated coronaviruses to trigger an immune response in the body. They have been shown in studies to be less effective than the vaccines developed by the pharmaceutical companies Pfizer and Moderna, which use newer mRNA technology.
Sinopharm’s vaccine initially came under scrutiny because of a lack of transparency in its late-stage trial data. The vaccine faced more questions after the island nation of the Seychelles, which relied heavily on Sinopharm to inoculate its population, also saw a spike in cases, although most people did not become seriously ill.
“Inactivated vaccines like Sinovac and Sinopharm are not as effective against infection but very effective against severe disease,” said Ben Cowling, an epidemiologist and biostatistician at the University of Hong Kong School of Public Health.
“Although Mongolia seems to be having a spike in infections and cases, my expectation is that there won’t be large number of hospitalizations,” he added.
And some virus variants may spread fast enough to cause concern even in countries where much of the population has vaccinations effective against them: Britain is dealing with a rise in cases linked to the Delta variant, despite having more than half of its adult population fully vaccinated, largely with shots from AstraZeneca and Pfizer.
Still, the wave of infections has raised questions in Mongolia over why the government relied on the Sinopharm shots instead of a vaccine proven to be more effective. It came as Mongolians headed to the polls on Wednesday to vote for president, the first election since the constitution was amended to limit the president to one six-year term. The prime minister is the head of government and holds executive power.
A year ago, Mongolia was among the few countries in the world that boasted no local coronavirus cases, but an outbreak in November changed that. A political crisis ensued and protests over perceived mishandling of the outbreak led the prime minister to resign in January.
The new prime minister, Oyun-Erdene Luvsannamsrai, has promised to revive a flagging economy and end social distancing restrictions that have hurt businesses. A fresh wave of cases could threaten this pledge.
Mastercard’s charitable arm has promised to donate $1.3 billion for vaccines in Africa, one of the largest corporate donations of the pandemic, as the continent struggles to contain a surge of infections.
The Mastercard Foundation said on Tuesday that its donation would be deployed over three years “in partnership” with the Africa Centers for Disease Control and Prevention. It said the goals were to strengthen the agency’s capacity, “lay the groundwork” for local vaccine manufacturing, acquire vaccines for at least 50 million people and help deliver shots to millions more.
“Ensuring inclusivity in vaccine access, and building Africa’s capacity to manufacture its own vaccines, is not just good for the continent, it’s the only sustainable path out of the pandemic and into a health-secure future,” John N. Nkengasong, the director of the Africa Centers for Disease Control and Prevention, said in the statement announcing the donation.
Africa is battling a sharp, sudden rise in coronavirus infections and deaths that experts believe is linked to the rise of new variants. The latest hot spots include Botswana, Namibia, Oman and Tunisia, according to a New York Times database.
But as of Wednesday only about 38 million, or slightly more than 2 percent, of the continent’s 1.3 billion people had received at least one dose of a coronavirus vaccine, according to the Our World in Data project. That was roughly the number of first doses given so far in Italy, which has a population of about 60 million.
Mastercard’s donation is the latest effort to address the glaring vaccination gap between rich and poor countries.
Last week a group of wealthy countries, foundations and private companies pledged $2.4 billion for global vaccination efforts and announced plans to share a total of 54 million doses from their domestic supplies with countries in need, for example.
The World Health Organization said last week that only 0.4 percent of all Covid-19 vaccine doses had been administered in low-income countries. And pharmaceutical companies have only manufactured a fraction of the 11 billion shots that researchers at Duke University estimate will be needed to vaccinate 70 percent of the world’s population, the rough threshold needed for herd immunity.