A digital Covid certificate system that will facilitate travel within the European Union became operational in seven countries on Tuesday — ahead of schedule — previewing what could become a standard for post-pandemic global mobility.
The document, known as a digital green certificate, records whether people have been fully vaccinated against the coronavirus, recovered from the virus or tested negative within 72 hours. Travelers can move freely if at least one of those three criteria is met.
Bulgaria, the Czech Republic, Denmark, Germany, Greece, Croatia and Poland made the certificates available to their citizens as of Tuesday and are accepting them for visitors. The European Commission, the bloc’s administrative branch, said the system would be used in all 27 E.U. countries as of July 1.
The digital green certificate was launched after two months of preparation, a relatively fast turnaround considering that it required coordination among the 27 countries and contains security features that validate the data’s authenticity. Because of concerns about privacy, the system’s data is not retained anywhere, the Commission said.
The long-term goal is for all people within the European Union to have the certificates and for visitors from outside the bloc to be able to receive one upon arrival. Providing them to outsiders could be tricky, however, considering that not all countries have been giving people secure vaccination documents.
The European Commission is in talks with the United States about how to verify the vaccination status of American visitors. It has also asked E.U. countries to start waiving testing and quarantine demands for people who are vaccinated or recently recovered from the coronavirus, and to stop requiring quarantines for people with a negative virus test.
While most of the United States’ prison systems have struggled to vaccinate inmates, those in California and some other states have outperformed vaccination rates among the general public. And experts say their success may offer clues about how to persuade skeptical people outside correctional facilities to get vaccinated.
“Education is really key,” said Lauren Brinkley-Rubinstein, a professor at the University of North Carolina School of Medicine who leads the Covid Prison Project, a group that tracks coronavirus cases in correctional settings and compiled the data on vaccination rates. “Especially in a prison context, where there tends to be a lot of distrust of both health care staff and correctional staff, that education piece becomes even more important.”
At one California prison, inmates held a town-hall-style meeting in which medical experts answered questions about the safety of the vaccines. In Rhode Island, formerly incarcerated people were involved in helping develop a vaccination plan for inmates. In Kansas, inmates were given priority for vaccinations, and prisons provided vaccine information to inmates’ relatives and to the inmates themselves.
About 73 percent of inmates in California and Kansas prisons have received at least one Covid vaccine dose, according to the project. In North Dakota, another state that has had prison town-hall meetings, the rate is above 80 percent.
By contrast, North Dakota’s overall vaccination rate is 42 percent. California has administered at least one shot to 56 percent of residents, and Kansas 47 percent.
Incarcerated people are at a much greater risk from Covid-19 than the general public, but many say that they are wary both of the vaccines and of the prison medical staff members who administer them.
Dr. Brinkley-Rubinstein and Aaron Littman, a law professor who tracks cases with the Covid-19 Behind Bars Data Project at the University of California, Los Angeles, said that providing information from knowledgeable sources — and administering inoculations where people live — made it easier to gain consent.
“When people know exactly where to go and how to get access, then it can be really successful, even in very hard-hit, traditionally underserved people,” Dr. Brinkley-Rubinstein said.
Kevin Ring, a former inmate who is president of Families Against Mandatory Minimums, a group that advocates for changes in sentencing laws, said that peer pressure also had an effect in some prisons.
“You could have no one taking it, but then if everyone’s taking it and then you’re in this small group of people — the peer pressure could work in a pro-vaccine way,” he said. “People want to return to unlimited movement throughout the prison, and they want their rec time back, and they want visits. And if they feel like there’s some weak links that are resisting, then I think there’s more pressure on those people.”
Moderna on Tuesday became the latest pharmaceutical company to apply to the U.S. Food and Drug Administration for full approval for its coronavirus vaccine for use in people 18 and older.
Last month Pfizer and BioNTech applied to the agency for full approval of their vaccine for use in people 16 and older.
“We look forward to working with the F.D.A. and will continue to submit data from our Phase 3 study and complete the rolling submission,” Stéphane Bancel, Moderna’s chief executive, said in a statement.
Moderna’s vaccine was authorized for emergency use in December, and as of Sunday, more than 151 million doses had already been administered in the U.S., according to data from the Centers for Disease Control and Prevention.
Moderna announced last week that its vaccine appeared to be highly effective in teenagers and that it planned to apply for emergency use authorization for adolescents in June. Pfizer’s vaccine was authorized for use in 12- to 15-year-olds last month.
Both the Moderna and Pfizer vaccines require two shots spaced several weeks apart, and are built around messenger RNA, the genetic material that cells read to make proteins, to help generate antibodies to the virus.
Full approval for each of the vaccines would allow the companies to market them directly to consumers and could make it easier for schools, employers and government agencies to require them. It could also encourage the U.S. military, which has had low uptake of vaccines, to mandate vaccinations for service members.
Approval could also help raise public confidence in another vaccine, after the pace of vaccinations has dropped sharply since mid-April.
A recent poll from the Kaiser Family Foundation showed signs that some hesitant people have been persuaded: About a third of people who had planned to “wait and see” whether they would get vaccinated said that they had made vaccine appointments or planned to do so.
“I think there are many people who were on the fence, who were worried about things moving too rapidly and about possible side effects,” said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and a vaccine expert. “But those concerns are being allayed as they see more of their friends and acquaintances celebrating getting vaccinated.”
Jan Hoffman contributed reporting.
With new coronavirus cases dropping to below 20 a day, Israel on Tuesday retired its Green Pass system and will now allow equal access to restaurants, sports events, cultural activities and the like to vaccinated and unvaccinated citizens.
Restrictions on the sizes of gatherings have also been lifted.
The decision came less than three months after Israel, a real-world laboratory for the efficacy of the Pfizer-BioNTech vaccine, pioneered its digitized Green Pass system and became a test case for an inoculated society.
For now, the only remaining pandemic restriction inside the country is a requirement to wear masks in closed public spaces, although that, too, is under discussion by health officials. The main efforts to control the coronavirus are now centered on restrictions for travel in and out of Israel, based on testing and quarantine. Strict limitations remain on the entry of people who are not Israeli citizens.
“The Green Pass project was very successful,” said Tomer Lotan, the policy chief of Israel’s national coronavirus response center, summing up the experiment of the past few months. It was particularly effective, he said, as an incentive to encourage the 16-to-40 age group to get vaccinated and to allow Israel to reopen its economy.
“But anybody who did not get vaccinated by now is probably not going to,” Mr. Lotan said.
About 81 percent of Israel’s adult population has been fully vaccinated, but about 2.6 million children under 16 are still not eligible, out of a total population of just over nine million. Up to a million people have chosen not to be inoculated, despite Israel’s enviable supply of vaccine doses.
Even with schools fully open and operating in a regular format, infection rates among children have remained low. In general, national infection rates are down to single digits on some days, from a peak of 10,000 a day in January.
Israel was among the first countries to grapple with some of the legal and moral issues arising from a two-tiered system for vaccinated and unvaccinated people. Because getting vaccinated has been voluntary, some people who chose not to or could not be vaccinated argued that the Green Pass system was discriminatory. Enforcement was also patchy.
With infection rates so low, Mr. Lotan said that the Green Pass had outlived its usefulness. Businesses complained about the additional burden of enforcing the rules. And movie complexes and other leisure attractions did not reopen, because it was unprofitable as long as unvaccinated children could not enter without showing a recent negative Covid-19 test, which many found impractical.
“A few months ago, if you would’ve told us we’d be in this current situation, it would probably seem like science-fiction,” said Nadav Davidovitch of the School of Public Health at Ben-Gurion University of the Negev.
The big question now, he said, is whether Israel has reached some degree of herd immunity. “Even if we are not there,” he said, “we are probably very close.”
The coronavirus has now claimed the lives of 32 lawmakers in the Democratic Republic of Congo — more than 5 percent of its Parliament — the authorities say, a reflection of how the coronavirus continues to pose a widespread threat in some parts of the world even as others increasingly resume pre-pandemic behavior.
The toll of the outbreak in Congo is also rising as the country struggles to roll out Covid-19 vaccines, fight off other deadly diseases and grapple with the eruption of one of the world’s most dangerous volcanoes.
“This pandemic is raging — decimating thousands of human lives and exploding in the process the rate of morbidity,” Jean-Marc Kabund, the first vice president of Parliament’s lower house, told lawmakers last week.
Congo — Africa’s second-largest country, with a population of more than 86 million — has reported over 31,000 coronavirus cases and 786 deaths, although those numbers probably vastly underestimate the scale of the outbreak because testing levels remain low nationwide.
The central African state has also struggled with its vaccination campaign. In early March, it received 1.7 million AstraZeneca shots from Covax, the global vaccine-sharing partnership. But the authorities delayed delivering the shots until mid-April after several European countries suspended their use because of very rare blood clots observed in small numbers of people who had received them.
By early May, fearing that the doses would expire before they could be used domestically, Congo announced the reallocation of 1.3 million of them to five other African countries.
As of Friday, more than 23,000 people — most of them in Kinshasa, the capital — had been vaccinated, according to the health ministry.
Along with concerns about the rare blood clots, vaccine hesitancy has been fueled by misinformation spread on social media, longstanding suspicion in government systems and a belief that diseases like Ebola and measles constitute more of a threat than Covid.
Last month, the United Nations Children Fund warned of a resurgence in other deadly diseases, including measles, polio and yellow fever, as parents remained reluctant to take their children to health centers for fear of exposure to Covid-19.
All of this comes as tens of thousands of people have fled the eastern city of Goma after the eruption of Mount Nyiragongo, one of the world’s most active volcanoes.
Since the beginning of the pandemic, several African leaders have succumbed to the coronavirus. In the Republic of Congo, the opposition presidential candidate Guy-Brice Parfait Kolélas died of Covid-19 in March just hours after voting ended. Abbay Kyari, a former chief of staff to Nigeria’s president, and the South African minister Jackson Mphikwa Mthembu both died of complications related to Covid-19.
Peru says that its Covid-19 death toll is almost three times as high as it had officially counted until now, making it one of the hardest-hit nations relative to its population.
In a report released on Monday that combined deaths from multiple databases and reclassified fatalities, the government said that 180,764 people had died from Covid-19 through May 22, almost triple the official death toll of about 68,000. The new figure would mean that more people have died in Peru relative to its population than in Hungary and the Czech Republic, the countries with the highest official death tolls per person, according to a New York Times database.
The report landed at a precarious moment for Peru’s government, just days before the second round of a closely watched presidential election.
Peru has struggled to contain the coronavirus since the pandemic began, and its official death toll before the revised estimate was already the ninth highest per capita in the world. As early as last June, far more deaths were occurring there than would be expected in a normal year, and the gap — a figure known as excess deaths — was much larger than the number of deaths officially attributed to Covid-19, according to New York Times data. That was a warning sign to experts that Covid deaths were being undercounted.
William Pan, who teaches global environmental health at Duke University, said the pandemic had underscored the deep inequality and corruption in Peru.
“Long before the stories of oxygen shortages in India and Manaus, Iquitos experienced this sad reality of Covid,” said Dr. Pan, referring to the largest Peruvian city in the Amazon. “Thousands of people were being turned away last April and May due to lack of oxygen, lack of space, medical staff being totally overwhelmed and more.”
Peru could be the first of several nations forced to reckon with a re-evaluation of the pandemic’s true impact. The World Health Organization said in May that deaths from Covid-19 globally were probably much higher than had been recorded.
Peru’s government will start publishing more accurate daily tallies of cases and deaths based on new guidelines laid out in the report, said Oscar Ugarte, the health minister.
The pandemic has intensified the political turmoil in Peru, which was rocked by the impeachment of President Martín Vizcarra in November. He was one of four presidents to serve in five years, three of whom spent time in jail during bribery investigations.
The virus is spreading faster in South America than on any other continent, according to official data, with five nations among the top 10 globally for new cases reported per person. Its worst outbreak is in Argentina, which was supposed to host the Copa América soccer tournament, before organizers announced that they were moving it to Brazil.
At the urging of business groups, the Equal Employment Opportunity Commission has made clear how companies can issue vaccine mandates to workers coming back to the office, and what incentives those employers can offer to promote inoculation.
Companies can require vaccines only of employees returning to the workplace, and not those who work outside the office, the E.E.O.C. said in guidance released on Friday. But doing so still counts as a mandate, so companies must give the same legally required considerations that companywide vaccine requirements would entail, like making accommodations under the Americans with Disabilities Act for employees who can’t receive the vaccine. That means allowing for exceptions for those who may be unable to take the vaccine for health reasons, like an allergy.
Jessica Kuester, an employment benefits lawyer at the law firm Ogletree Deakins, said that specification was important. “I worry that some employers were sort of going down the wrong path, and thinking that it wasn’t that big of a deal to have a vaccination requirement,” she said.
The E.E.O.C. acknowledged in its guidance there may be other laws — like state laws — offer opposing views. And it reminded employers to consider the fact that access to the vaccine is not yet equitably distributed.
“Employers should keep in mind that because some individuals or demographic groups may face greater barriers to receiving a Covid-19 vaccination than others, some employees may be more likely to be negatively impacted by a vaccination requirement,” the agency wrote.
Employers can also offer vaccine incentives, as long as they are not coercive, the E.E.O.C. clarified. (Under nondiscrimination rules laid out in the Health Insurance Portability and Accountability Act, that could mean, for example, offering 30 percent discount of the total cost of medical plan coverage).
Employers can offer enticements like paid time off to get vaccinated — which Darden Restaurants and many other companies have done, as well as rewards for employees who show proof of inoculation, like the $75 bonus that Walmart is offering. Companies have also been offering the opportunity to go mask-free at the office as a type of inducement, though several aren’t asking for proof of vaccination, perhaps as a concession to practicality.
“Are you really going to go around and, when you see an employee without a mask, are you going to run back to H.R. and verify that that person really was fully vaccinated?” Ms. Kuester said.
Congress has passed laws barring pharmacies and hospitals in the United States from billing patients for coronavirus vaccines. Signs at vaccination sites advertise that the shots are free. From the beginning, health officials and government leaders have told the public that getting the inoculation won’t cost anything. And there have been few reports of people experiencing charges.
Even so, some unvaccinated adults cite concerns about a surprise bill as a reason for not getting vaccinated. Many are accustomed to a health system in which bills are frequent, large and often unexpected.
A recent Kaiser Family Foundation poll found that about a third of unvaccinated adults were unsure whether insurance covered the vaccines and were concerned that they might need to pay. The concern was especially pronounced among Hispanic and Black survey respondents.
Congress has tried to protect people from bills for coronavirus vaccines and tests. Early in the pandemic, it mandated that insurers waive co-payments and deductibles for both services and set up a fund to reimburse doctors seeing uninsured patients.
Even so, people found themselves facing bills for testing — some for over $1,000. Some doctors billed uninsured patients for tests rather than the new federal fund.
The rules for vaccine billing were made even stricter. To become vaccinators, doctors and pharmacies had to sign a contract promising not to bill patients for shots.
The stronger protections appear to have worked. While many people have encountered bills for testing, there have been only a handful involving vaccines.
In the story of how the modern world was constructed, Toyota stands out as the mastermind of a monumental advance in industrial efficiency. The Japanese automaker pioneered “just in time” manufacturing, in which parts are delivered to factories right as they are required, minimizing the need to stockpile them.
Over the last half-century, the approach allowed companies to stay nimble while cutting costs. But the tumultuous events of the past year have challenged the merits of paring back inventories and reinvigorating concerns that some industries have gone too far.
As the pandemic has hampered factory operations and scrambled global shipping, many economies have been bedeviled by shortages of a vast range of goods.
The most prominent manifestation of this dynamic has surfaced in the very industry that invented the “just in time” practice: Automakers have been crippled by a shortage of computer chips — vital car components produced mostly in Asia.
But the breadth and persistence of the shortages reveal the extent to which the “just in time” idea has come to dominate commercial life. It helps explain why Nike and other apparel brands have struggled to stock retail outlets with their wares and is one reason construction companies are having trouble buying paints and sealants.
It was also a principal contributor to the shortages of personal protective equipment early in the pandemic.
Players from Australia’s national women’s softball team arrived in Japan on Tuesday ahead of the Tokyo Olympics, a show of confidence in a beleaguered event that is struggling against a coronavirus outbreak and growing public opposition.
Twenty players and 10 staff members, all of whom have been vaccinated against Covid-19, landed at Narita International Airport outside Tokyo and traveled to the city of Ota, where they will train before moving into the Olympic Village on July 17. They are among the first international competitors to reach Japan before the Games.
The team, known as the Aussie Spirit, must strictly limit its movements as Japan tries to contain a prolonged fourth wave of the coronavirus. On Friday, the Japanese government extended a state of emergency in Tokyo and eight other prefectures until June 20. In other prefectures — including Gunma, where the Australian players will train — emergency measures curtailing businesses’ operating hours and capacity at certain venues are set to expire on June 13.
New daily infections in the country have declined more than 40 percent in the past two weeks, according to a New York Times database, but Japan is still recording more than 3,500 cases per day, the most since January.
The Australian team will be confined to one level of a hotel, where the players will eat meals, work out and have meetings. They will be able to leave the hotel only to train.
“They’ll be extremely limited in what they’ll be able to do every day, and that’s going to take, for them, another sacrifice, but it’s a sacrifice they’re up for,” Ian Chesterman, vice president of the Australian Olympic Committee, said on Monday.
The players have not competed against any international teams since February 2020, as Australia’s borders have been almost completely closed since the start of the pandemic. Their early arrival will allow them to train against professional Japanese softball clubs and the Japan national team. Of 23 Australian players who will train in Japan, a team of 15 will be selected to compete in the Games, which are scheduled to begin on July 23.
If the rainy, chilly Memorial Day weekend in New York City meant that barbecues and beach trips were called off, it revived another kind of rainy-day tradition in the city: lining up to see art, hear music and catch films, in a way that felt liberating after more than a year of the pandemic.
The rising number of vaccinated New Yorkers, coupled with the recent easing of many coronavirus restrictions, made for a dramatic and happy change from Memorial Day last year, when museums sat eerily empty, nightclubs were silenced and outdated posters hung outside closed movie theaters.
At the Metropolitan Museum of Art, Saturday and Sunday each drew more than 10,000 visitors, a record for the museum during the pandemic, and roughly double the numbers of two months ago before the state loosened capacity restrictions.
Of course, the pandemic is not yet over: An average of 383 cases per day are being reported in New York City. But that is a 47 percent decrease from the average two weeks ago.
There were plenty of physical reminders of the pandemic, too, with masks, temperature checks and social distancing still a part of life in many places.
New York State officials hope that the Excelsior Pass, introduced in March as the first government-issued vaccine passport in the United States, can help people feel confident about the safety of businesses and can jump-start a statewide economy that is still reeling from the pandemic.
For that to happen, they will need more people and businesses to start using it.
The passport — a QR code on a smartphone that indicates a person’s vaccine status — and vaccine passports in general have become a political flash point, as some people argue that the passports violate privacy concerns.
New York says that about 1.1 million Excelsior passes have been downloaded onto phones and computers, a small fraction of the 8.9 million New Yorkers who have been fully vaccinated.
Nationally, states like Alabama, Arizona, Florida and Georgia have banned the use of vaccine passports. And in New York, some lawmakers are backing new legislation that would provide additional privacy protection.
Although major sports venues and a growing number of smaller New York businesses are embracing the Excelsior Pass, most businesses are not requiring proof of vaccination to enter.
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