Covid: C.D.C. Director Says Choice Is to ‘Get Vaccinated or Continue to Wear Your Mask’

The C.D.C. director offers a stark reassurance: Only unvaccinated people are at risk by unmasking.

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Dr. Rochelle P. Walensky during a Senate Health, Education, Labor and Pensions Committee hearing last week.Credit...Pool photo by Greg Nash

The head of the Centers for Disease Control and Prevention, facing blowback over the agency’s new liberalized mask guidelines, offered a stark reassurance on Sunday: Only unvaccinated people are at risk if they take off their masks.

“If you are vaccinated, we are saying you are safe, you can take up your mask and you are not at risk of severe disease or hospitalization from Covid-19,” the C.D.C. director, Dr. Rochelle P. Walensky, said on “Fox News Sunday.” “If you are not vaccinated, you are not safe. Please go get vaccinated or continue to wear your mask.”

Dr. Walensky’s appearance on Fox was part of a round of appearances on Sunday talk shows that came in the wake of the fresh guidelines and the confusion that has accompanied them.

The guidance the C.D.C. issued on Thursday said that it was no longer necessary for fully vaccinated people to mask or maintain social distance in many settings. The change set off public confusion and drew objections from some local officials and labor unions, including the country’s largest union of registered nurses. A number of major U.S. retailers have already lifted mask requirements, essentially turning to an honor system that relies on unvaccinated people to keep their masks on in public.

In her interviews on the Sunday news shows, Dr. Walensky revealed a subtle but marked shift in her agency’s emphasis from community to individual protection. She acknowledged on Fox that “for 16 months, we’ve been telling people to be cautious, be careful, cases are going up,” and made clear that the C.D.C.’s new bottom line is that individuals could make their own choices.

She also noted that communities where cases are high should consider keeping mask requirements, and that children who are not vaccinated — including everyone under 12 because they are not yet eligible for the shot — and people with compromised immune systems should keep their faces covered.

“This was not permission to shed masks for everybody everywhere,” Dr. Walensky said on the NBC program “Meet the Press,” but about “individual assessment of your risk.”

On Saturday, the C.D.C. recommended the continued, universal use of masks and physical distancing in schools. “Our school guidance to complete the school year will not change,” Dr. Walensky said on “Fox News Sunday,” adding that the agency would work over the summer to update its school guidance for the fall.

On a practical level, jurisdictions, including communities, schools and employers, look to the C.D.C. for guidance as they set policy. The new recommendations create the possibility that there will be an increasing number of unmasked people in public venues with no certainty that they have been vaccinated.

Dr. Walensky rejected the idea that pressure from the public and from elected officials frustrated by more than a year of restrictions had prompted the new guidance, saying that it stemmed entirely from evolving science that shows the vaccines protect not just against getting severely ill from the virus and its variants but also against spreading them.

In interviews this weekend with dozens of residents from Los Angeles to Atlanta, people said they were mostly encouraged by the C.D.C.’s new recommendations. But the details, many said, were perplexing and had stirred new questions about science, and also about trust, social norms and even politics.

Since the start of the pandemic, many conservatives have bristled at being told they should wear face coverings, while many liberals often took pride in masking, making mask mandates a constant source of debate and division. But the new guidance is creating tumult in the parts of the country where masks had remained common.

“At first, as a citizen, I was like, ‘Wow, these are so great. I haven’t been out to eat in a year,’” Angela Garbacz, 34, a pastry shop owner in Lincoln, Neb., said of the new recommendations. “But as a private business owner, it has been like panic and, ‘What do we do?’ Are people just going to think they can come in without masks? Do I get rid of my mask requirement? It’s just so much uncertainty with the one thing that’s helped us feel safe in a really scary time.”

A wave of pandemic refugees at the U.S.-Mexico border has caught the Biden administration by surprise.

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A U.S. Border Patrol agent questioning undocumented migrants who walked towards the opening of the border wall in Yuma, Ariz., this month.Credit...Ariana Drehsler for The New York Times

The Biden administration is struggling with a new and different wave of migration along the southwestern border: pandemic refugees.

These are people arriving in ever greater numbers from far-flung countries where the coronavirus has caused unimaginable levels of illness and death and decimated economies and livelihoods.

At the U.S.-Mexico border in recent months, agents have stopped people from more than 160 countries, and the geography coincides with the path of the virus’s worst devastation.

More than 12,500 Ecuadoreans were encountered in March, up from 3,568 in January. Nearly 4,000 Brazilians and more than 3,500 Venezuelans were intercepted, up from just 300 and 284, respectively, in January. The numbers in coming months are expected to be higher.

Some migrants from India reported taking buses in their hometowns to a big city, like Mumbai, where they boarded planes to Dubai and then connected through Moscow, Paris and Madrid, finally flying to Mexico City. From there, they embarked on the two-day bus ride to reach the Mexico-U.S. border. 

Many of them are entering the United States through wide openings in the border wall near Yuma, Ariz. Border Patrol agents working in the Yuma sector said the number of migrants arriving there now dwarfs the surge of Central Americans two years ago that prompted some of the harsh immigration measures imposed by former President Donald J. Trump. They said they were struck by how far people had traveled.

Though no records are kept at the border on the reasons people have cited in choosing to move, interviews with many of those arriving, along with Border Patrol officials, shelter operators and immigration scholars, suggested that the job collapse brought about by the coronavirus — coupled with the Biden administration’s more welcoming policies — is driving much of the new surge.

Tracking the Coronavirus ›

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In Brazil, babies and small children are dying of the virus in disturbingly high numbers.

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Ariani Roque Marinheiro at her home last month in Maringá, Brazil. Her daughter, Letícia, a toddler, died in February from Covid.Credit...Victor Moriyama for The New York Times

Covid is ravaging Brazil, and, in a disturbing new wrinkle that experts are working to understand, it appears to be killing babies and small children at an unusually high rate.

Since the start of the pandemic, more than 434,000 people are known to have died of Covid in the country, and according to Brazil’s health ministry, 832 of them were children age 5 and under. The number is likely substantially larger, because a lack of widespread testing means many cases go undiagnosed.

Comparable data is scarce because countries track the impact of the virus differently, but in the United States, which has a far larger population than Brazil, and a higher Covid death toll, 139 children 4 and under have died.

Dr. Fátima Marinho, an epidemiologist at the University of São Paulo, is leading a study tallying the death toll among children based on both suspected and confirmed cases. She estimates that more than 2,200 children under 5 have died since the start of the pandemic, including more than 1,600 babies less than a year old.

“It’s a number that’s absurdly high,” Dr. Marinho said. “We haven’t seen this anywhere else in the world.”

The P.1 variant that emerged in Brazil appears to be one factor. “We can already affirm that the P.1 variant is much more severe in pregnant women,” said Dr. Ribas Freitas. “And, oftentimes, if the pregnant woman has the virus, the baby might not survive or they might both die.”

Lack of timely and adequate access to health care for children once they fall ill is likely another factor, experts said.

The assault on Gaza halts Covid shots and could spread the virus, U.N. officials warn.

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A staff member of the World Health Organization receives a Covid vaccine in March in Gaza City.Credit...Mohammed Salem/Reuters

Israel’s airstrikes and shelling of Gaza have stopped all coronavirus vaccinations and testing in the Palestinian enclave and raise the risk of superspreading as civilians cram into shelters for safety, United Nations officials said.

In an interview over Zoom on Friday as the sound of Israeli explosions shook their headquarters, the leaders of the U.N. Palestinian relief agency’s operations in Gaza and the head of the World Health Organization’s Gaza sub-office said they feared that a severe worsening of virus infections would be a side-effect of the death and destruction from the latest surge in hostilities.

The number of people in Gaza sickened from Covid-19 had been “just leveling off, and then this hit,” said the U.N. relief agency official, Matthias Schmale. “It is a grim situation.”

He said that unvaccinated Gazans were crowding into the schools run by his agency, known as the United Nations Relief and Works Agency, because the Israelis did not intentionally target those buildings — in effect making them bomb shelters. Now, Mr. Schmale said, those schools “could turn into mass spreaders.”

Last month, severe and critical cases of Covid hit highs in Gaza, which health experts attributed to the proliferation of the highly transmissible coronavirus variant first identified in Britain. In early May, Doctors Without Borders reported that the territory’s infections were topping 1,000 a day.

Sacha Bootsma, the W.H.O. official, said that before the vaccinations had stopped, 38,000 people in Gaza had received at least one dose of vaccine. That is less than 2 percent of the population of two million. Russia’s Sputnik vaccine and the Pfizer-BioNTech vaccine were given at three Gaza hospitals, and AstraZeneca’s vaccine was being administered at smaller health centers.

But now, Ms. Bootsma said, “People are not daring to visit health facilities. We are fearing this will have a major negative impact.”

By contrast, more than 60 percent of the Israeli population has received at least one dose of either the Pfizer-BioNTech or Moderna vaccines, and more than 55 percent are fully vaccinated, according to the Our World in Data project at the University of Oxford. However, the pace of vaccinations has slowed tremendously in recent months.

Under Covax, the international collaboration to provide vaccines to poor parts of the world, Gaza is supposed to receive enough vaccine to protect 20 percent of its population, the officials said.

But the deliveries, flown to Israel’s Ben Gurion Airport and then sent by land across the border to Gaza, have been indefinitely suspended because air service into Israel has been curtailed by the hostilities. Assuming they resume soon, it still remains unclear when Gaza’s border crossings might reopen.

“The biggest problem now is the borders are closed,” Mr. Schmale said. “Even if there were a delivery, we would not be able to receive any supplies.”

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India, crushed by Covid and now facing a cyclone, cancels many vaccinations.

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Members of India’s National Disaster Response Force clearing fallen trees on Sunday in Goa, a state south of Gujarat on India’s western coast.Credit...National Disaster Response Force, via Agence France-Presse — Getty Images

A severe cyclone expected to make landfall in India’s northwest state of Gujarat on Sunday evening forced officials to suspend coronavirus vaccinations in parts of the Covid-ravaged country, including the city of Mumbai, at least until Tuesday.

Heavy rainfall and winds from the storm, Cyclone Tauktae, have already killed at least six people and prompted tens of thousands more to evacuate their homes. But the storm’s effects could be far graver, coming as India is grappling with a terrible wave of illness and death from the coronavirus that has left hospitals filled to capacity and sick people struggling to get care.

More than 266,200 people in India have died from the virus, but experts say that is almost certainly an undercount. India reported 4,106 new deaths and an additional 281,386 coronavirus infections on Monday.

Officials in Gujarat said that arrangements had been made for patients at Covid centers to continue to receive treatment. Hospitals were sealing windows and doors, and more than 170 mobile intensive care unit vans were being deployed to provide emergency care, according to local media.

Dozens of disaster management teams have been deployed in several states, along with army, navy and coast guard units, the government said, adding in a statement on Sunday that it was taking steps to ensure “zero loss of life.”

In other news around the world:

  • On Monday, Portugal will begin allowing visitors from Britain again. The reopening comes after the British government agreed to include Portugal on a list of countries where travelers will be allowed to visit and not have to quarantine upon returning. The reopening could be a major boon for Portugal’s summer tourist season, as the British form the largest contingent of foreign visitors to the country. Thousands of English soccer fans are already set to travel to Portugal to attend the Champions League final in Porto on May 29.

  • Days after ending its divisive ban on allowing citizens to return from India, Australia carried out its first repatriation flight from that country, with the plane departing from New Delhi and arriving in Darwin, in Australia’s Northern Territory, on Saturday. The flight had been scheduled to carry 150 passengers, but just 80 people were on it, after 70 people were barred from travel because they or their close contacts had tested positive for Covid-19, according to the Australian government. The new arrivals in Australia now face two weeks of quarantine in a converted mining camp outside Darwin.

  • Turkey will start to ease strict lockdown measures on Monday, shifting to a less restrictive program that still mandates curfews on weeknights and weekends, The Associated Press reported. Shopping malls will be allowed to reopen, and while some businesses like gyms and cafes have to stay closed, restaurants will be permitted to offer takeout and delivery services. Turkey reported an average of 12,960 new daily cases on Saturday, down from a peak of about 60,200 in late April, according to the Our World in Data project at the University of Oxford.

In a new vaccination push, Biden leans on his ‘community corps.’

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Dr. Ala Stanford, founder of the Black Doctors Covid-19 Consortium, discussed outreach efforts with her team last week at their vaccine clinic in Philadelphia.Credit...Rachel Wisniewski for The New York Times

Only a trickle of people had visited her community vaccination site in Philadelphia seeking a first coronavirus shot last Monday when Dr. Ala Stanford, a local pediatric surgeon, seized on an unexpected opening.

Across the street, a funeral home was holding services, including one for a victim of Covid-19. She mocked up new fliers, then delivered them to the funeral home. By the afternoon, several workers and guests had crossed the street to get inoculated.

The scene underscored what the Biden administration has called a new phase of its vaccination campaign.

The federal government has set up mass vaccination sites, sent doses to pharmacies and clinics serving lower-income Americans, and, on Friday, enticed the unvaccinated with the prospect of finally being able to shed their masks.

But with the ranks of the willing and able dwindling, the campaign has in many places already morphed into a door-to-door and person-by-person effort.

The Black Doctors Covid-19 Consortium, which Dr. Stanford leads, is one of about 11,000 members of what the Department of Health and Human Services is calling its Covid-19 community corps: volunteers, corporations, advocacy groups and local organizations working to vaccinate Americans often left behind by the nation’s health care system.

Begun last month, the network operates on the belief that once the people most eager for a shot were done, those left unvaccinated will prefer to get their shots by or around people they know.

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A desperate India falls prey to Covid scammers.

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A man pleaded for his oxygen cylinder to be refilled at a local shop in Delhi earlier this month.Credit...Atul Loke for The New York Times

A coronavirus second wave has devastated India’s medical system and undermined confidence in the ability of Prime Minister Narendra Modi’s government to treat its people and quell the disease. There are widely believed to be far more deaths than the thousands reported each day. Hospitals are full. Drugs, vaccines, oxygen and other supplies are running out.

Pandemic profiteers are filling the gap. Medicine, oxygen and other supplies are brokered online or in hushed phone calls. In many cases, the sellers prey on the desperation and grief of families.

Sometimes the goods are fraudulent, and some are potentially harmful. Last week, police officers in the state of Uttar Pradesh accused one group of stealing used funeral shrouds from bodies and selling them as new. The day before, officers in the same state discovered more than 100 vials of fake remdesivir, an antiviral drug that many doctors in India are prescribing despite questions about its effectiveness.

Over the past month, the New Delhi police have arrested more than 210 people on allegations of cheating, hoarding, criminal conspiracy or fraud in connection with Covid-related scams. Similarly, the police in Uttar Pradesh have arrested 160 people.

We gathered scenes from America’s reopening.

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Students from Studio Arts for Dancers prepare to perform for a limited live crowd at the Tennessee Theater. The theater has recently started allowing a few performances to have small audiences after a year of virtual-only performances.Credit...Shawn Poynter for The New York Times

With climbing vaccinations and dwindling virus cases, Americans from Honolulu to Sumter, S.C., have begun to return to the things they did before — the nights out, religious services and annual traditions that made life richer. But after a year of isolation, it has all been a bit uncertain, both familiar and not quite.

Photographers for The Times documented Americans re-emerging in all 50 states in recent weeks. The approach to reopening has been much like the nation’s patchwork response to the virus: conflicting guidance, competing narratives and Americans left to gauge their own comfort levels.

Photos also captured businesses reopening, friends and families gathering and devastated performers taking the stage again.

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A major nurses’ union condemns the C.D.C.’s new mask advice for vaccinated people.

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Bonnie Castillo, executive director of National Nurses United, last year in Oakland, Calif. Ms. Castillo is condemning the Centers for Disease Control and Prevention’s lifting of mask recommendations for vaccinated people.Credit...Justin Sullivan/Getty Images

The nation’s largest union of registered nurses condemned the Centers for Disease Control and Prevention on Saturday for lifting mask recommendations for vaccinated people and called on the agency to “do the right thing” and revise its guidance.

Bonnie Castillo, a registered nurse and executive director of the union, National Nurses United, said the most recent guidance, which was issued on Thursday and rolled back mask recommendations and other precautions for those who are fully vaccinated, “is not based on science.” Ms. Castillo said the new guidance would jeopardize the health of frontline workers and the general public and would disproportionately harm people of color.

Many major U.S. retailers have dropped mask requirements since Thursday, effectively moving to an honor system in which they trust that only vaccinated people will bare their faces.

“This is a huge blow to our efforts at confronting this virus and the pandemic,” said Ms. Castillo, whose union represents 170,000 nurses nationwide. “The mask is another lifesaving layer of protection for workers,” she said.

Although vaccination is vitally important to stopping the virus’s spread, she noted that millions of Americans still had not been vaccinated. Less than half of the population has had a single dose of vaccine, and less than 40 percent are fully vaccinated.

The union also criticized the C.D.C. for other actions, including its decision to stop monitoring breakthrough infections among vaccinated individuals and to investigate such cases only if they result in a hospitalization or death. The agency announced that, as of May 1, it would no longer track or investigate all infections among vaccinated people so that it could “maximize the quality of the data collected on cases of greatest clinical and public health importance.”

The nurses said that meant the C.D.C. would not gather the data necessary to understand whether vaccines prevent mild and asymptomatic infections, how long vaccine protection lasts and what role variants play in breakthrough infections.

The union also called on the agency, which recently recognized that the virus could be transmitted through aerosolized particles, to update its guidance about ventilation and respiratory protection accordingly. The union also called on the Occupational Safety and Health Administration to immediately issue emergency temporary standards on infectious diseases to protect people in the workplace.

The C.D.C. did not immediately respond to the criticisms. Introducing the new recommendations on Thursday, Dr. Rochelle P. Walensky, the C.D.C. director, cited two recent scientific findings as significant factors: Few vaccinated people become infected with the virus, and transmission seems rarer still; and the vaccines appear to be effective against all known variants of the coronavirus.

The union noted that more than 35,000 new cases of coronavirus were being reported each day and that more than 600 people were dying each day. “Now is not the time to relax protective measures, and we are outraged that the C.D.C. has done just that while we are still in the midst of the deadliest pandemic in a century,” Ms. Castillo said.

‘It’s the vaccinations’: Virus cases drop significantly in the Northeast.

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A vaccination site at Central Falls High School in Rhode Island in February. Rhode Island is one of several northeastern states with significantly decreased infection rates and hospitalizations.Credit...Joseph Prezioso/Agence France-Presse — Getty Images

States in the U.S. Northeast, after experiencing spikes in coronavirus infections earlier this year, are reporting significant drops in cases and hospitalizations.

Connecticut, Massachusetts, Pennsylvania and Rhode Island have all reported many fewer cases in recent weeks as more people receive vaccinations. New York and New Jersey have also seen steady declines in cases after struggling to contain the virus earlier this spring.

Reported cases across the United States reached a high in January, and then, as vaccinations accelerated, fell through February and most of March. A much smaller overall surge peaked in mid-April, but has dropped about 32 percent over the past two weeks, according to a New York Times database. Hospitalizations and deaths are also ticking down, even as the pace of vaccinations has slowed in recent weeks.

In Rhode Island, confirmed cases have dropped 48 percent and hospitalizations have dropped 23 percent in the past two weeks. State officials attribute the fall in cases to increased vaccinations.

“It’s the vaccinations,” Gov. Daniel McKee of Rhode Island said, adding that “the vaccinations are really our focus right now.”

The state announced on Friday that it would adopt the Centers for Disease Control and Prevention’s new guidelines eliminating most mask requirements for fully vaccinated people starting on Tuesday. Although Mr. McKee expressed concerns that unvaccinated people might stop wearing masks too, he said he hoped the C.D.C.’s new guidance would encourage more people to get vaccinated and that it was “not a pass for people who have not been vaccinated.”

State officials are still worried about the threat of more contagious variants of the virus, he said. And even though Rhode Island’s vaccination campaign is ahead of most states’, Mr. McKee said that convincing people who were hesitant was still a challenge. About 57 percent of Rhode Island’s population has received at least one dose, and 46 percent have been fully vaccinated, according to a New York Times vaccine tracker.

In Pennsylvania, reported cases have dropped 44 percent and hospitalizations have dropped 28 percent in the past two weeks. Cases in the state started to rise in mid-March and continued to climb for weeks before reversing course in late April.

Alison Beam, Pennsylvania’s acting secretary of health, said the state’s vaccination effort had “made great strides,” which had led to the decreases. About 55 percent of the state’s population has received at least one shot, and 39 percent have been fully inoculated.

“One of our greatest hesitancy strategies is making it really convenient for folks and we’ve been able to do that by spreading out the vaccine to more of our provider networks more recently because the supply has increased as well,” Ms. Beam said.

With the pace of vaccinations falling, the Biden administration has been focused on door-to-door and person-by-person efforts. The Department of Health and Human Services recently started a “Covid-19 community corps,” a loose group of volunteers, corporations, advocacy groups and local organizations working to vaccinate Americans who may prefer to get their shots by or around people they know.

Ms. Beam cautioned, however, that coronavirus testing had also decreased in the state and she urged people to continue getting tested if they showed symptoms.

Although reported cases are continuing to drop nationwide, public health experts warn that the United States will have to continue aggressively vaccinating its population over the next few months. It is possible that the virus could surge again more widely in fall and winter, when viruses like the flu are typically dominant.

“That would be a terrible shame because that will include serious cases and deaths, and that’s preventable,” said Dr. Sten Vermund, the dean of the Yale School of Public Health.

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A vaccine from Sanofi and GSK is said to produce strong immune responses in a midstage study.

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Sanofi’s headquarters in Paris.Credit...Benoit Tessier/Reuters

Sanofi, the French pharmaceutical company, said on Monday that it would move the experimental Covid-19 vaccine it is developing with GlaxoSmithKline into a late-stage trial after the shot produced strong immune responses in volunteers in a midstage study.

The findings are encouraging for a vaccine that has fallen behind in development and has so far disappointed those expecting that it would be crucial in combating the pandemic. If the vaccine can become available in the last three months of this year, as its developers hope, it could still play a central role as a booster shot as well as an initial inoculation in the developing world, where the pace of vaccination is lagging.

The vaccine hit a major setback in December, when its developers announced that it did not appear to work well in older adults and that they would have to delay plans to test it in a Phase 3 trial, the crucial test that will assess the vaccine’s effectiveness.

But the companies modified the vaccine and in February began testing it in a Phase 2 study that included more than 700 volunteers in the United States and Honduras between 18 and 95 years old. Sanofi said the vaccine did not raise any safety concerns and produced a strong immune response across age groups, a finding suggesting it has been successfully tweaked.

Sanofi announced the findings in a statement and said it plans to soon publish the results in a medical journal.

Sanofi and GSK are much more experienced in vaccine development than a number of their rivals that have already won authorization. The two companies used a more established approach than those deployed in other, more swiftly developed Covid vaccines. Their shot is based on viral proteins produced with engineered viruses that grow inside insect cells. GSK is supplying the Sanofi vaccine with an adjuvant, an ingredient used in many vaccines meant to boost the immune response.

Sanofi and GSK’s vaccine was one of six selected for funding from Operation Warp Speed, the Trump administration’s effort to accelerate vaccine development. Last summer, the federal government agreed to give the companies $2.1 billion to develop and manufacture the vaccine, in exchange for 100 million doses once the shot was ready.

Sanofi also has supply deals with the European Union and Canada. It has also agreed to supply 200 million doses to Covax, the program to deliver vaccines to middle- and lower-income countries that has been struggling with a shortfall in expected doses. Sanofi has also announced plans to help manufacture the authorized vaccines made by Pfizer-BioNTech, Moderna and Johnson & Johnson.

Sanofi said its Phase 3 trial of its vaccine would begin in the coming weeks and enroll more than 35,000 adult volunteers around the world. It will test two formulations of the vaccine, one aimed at preventing the original strain of the virus and the other aimed at the B.1.351 variant first seen in South Africa that some vaccines appear to be less effective against.

Su-Peing Ng, Sanofi’s global head of medical for vaccines, told journalists on Monday that the company expected it to be “operationally quite challenging” to enroll unvaccinated participants in the Phase 3 trial as vaccination coverage increases in many nations. Still, she said, vaccine doses were still scarce in many parts of the world, pointing to Latin America and Asia as places where the company may look to enroll volunteers.

The company said that soon after starting the Phase 3 trial it planned to assess whether its vaccine could boost immune responses in people who had been vaccinated months before with authorized vaccines. Those booster studies are expected to enroll volunteers in well-vaccinated parts of the world, including the United States and Europe.

Sanofi and GSK said last year they were preparing to be able to make 1 billion doses annually. Thomas Triomphe, Sanofi’s global head of vaccines, said on Monday that the company’s production this year, if its vaccine were shown to work, would depend on the world’s needs.

The vaccine, he said, has “potential to be a booster of choice for many nations and many different platforms.”

Is the U.S. doing enough to fight the global pandemic? Many experts and business leaders say no.

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President Biden watched as vaccines were loaded into cold storage during a tour of the Pfizer Kalamazoo Manufacturing Site in Michigan in February.Credit...Doug Mills/The New York Times

A growing and bipartisan chorus of foreign policy experts, diplomats, global health advocates and prominent business leaders are pushing President Biden to take a more aggressive stance in combating the international coronavirus pandemic by scaling up vaccine manufacturing and exporting surplus doses.

In two open letters to the president, one released last week and the other early Monday, a string of prominent names urged Mr. Biden to do more.

The first letter came from top executives including Suzanne Clark, the president of the U.S. Chamber of Commerce; former ambassadors including John Negroponte, envoy to Iraq and the United Nations under President George W. Bush; and a former defense secretary, William Cohen, who served President Bill Clinton.

“The world has come to rely upon U.S. leadership at times of great strife,” Ms. Clark, Mr. Cohen, Mr. Negroponte and the others wrote, adding: “Today we have a generational opportunity to mobilize vaccine efforts around the world. Our friends and allies will not forget easily if we sit on surplus stockpiles of the most proven vaccines as their citizens suffer and die.”

The second letter, organized by four global health institutes and signed by experts including Mark McClellan, the Food and Drug Administration commissioner under Mr. Bush, called on Mr. Biden to, among other things, name a global coronavirus coordinator and “commit to sharing Covid-19 vaccine doses immediately.”

Mr. Biden has promised he would restore America as a leader in global health, and the letters indicate that a broad array of leaders in multiple sectors believe he has not gone far enough.

The Biden administration has already committed $4 billion to Covax, the effort by the World Health Organization to get vaccines into the arms of people in disadvantaged nations; pledged to work with Australia, India and Japan to bolster global vaccine supply; and has said it would send 60 million doses of the American supply of AstraZeneca vaccine for global deployment.

On Monday Mr. Biden announced that the U.S. would send an additional 20 million doses of authorized vaccines abroad in June.

“We need to help fight the disease around the world to keep us safe here at home,” Mr. Biden said.

Those 80 million doses amounted to five times the number that any other country had donated, Mr. Biden said, noting that taking the lead in helping the world beat back the coronavirus was a chance to reassert American authority.

“We want to lead the world with our values, with this demonstration of our innovation and ingenuity and the fundamental decency of the American people,” Mr. Biden said. “Just as in World War II America was the arsenal of democracy, in the battle against the Covid-19 pandemic our nation’s going to be the arsenal of vaccines for the rest of the world.”

To further broaden global supply, Mr. Biden recently announced he would support waiving intellectual property protections for coronavirus vaccines.

But J. Stephen Morrison, a global health expert at the Center for Strategic and International Studies who helped organize Monday’s letter, said suspending intellectual property rights would not help without White House leadership. “The world is now in great need of high-level engagement that up to now has been conspicuously absent,” his letter said.

The pharmaceutical industry opposes waiving the Agreement on Trade-Related Aspects of Intellectual Property Rights, known as TRIPS, and the letter from the business leaders and ambassadors argued that such a waiver “would make little difference and could do harm.”

Global health activists, who are strongly in favor of the waiver, said they nonetheless welcomed the business approach. They see clear parallels to their work fighting the global AIDS epidemic.

“It shows an unprecedented willingness of pharma and its allies in the private sector to admit what all of us having been saying for months, the private sector alone cannot and will not ensure global vaccine access,” James Krellenstein, a founder of PrEP4All, a nonprofit aimed at ensuring universal access to H.I.V. prevention and treatment, wrote in an email message.

“It really shifts the burden to the Biden administration,” Mr. Krellenstein wrote, adding, “When will they act?”

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A new law in India makes it harder for foreign aid to reach Covid patients, critics say.

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People receiving oxygen in Delhi last month.Credit...Atul Loke for The New York Times

India’s devastating Covid-19 surge has galvanized corporations, nonprofit organizations and individuals in the United States to raise millions of dollars and send medical supplies to assist the nation of 1.4 billion.

But a sweeping change to India’s law governing foreign donations is choking off aid just when the country needs it desperately. It is struggling through a second wave of coronavirus that, since beginning in mid-March, has more than doubled the country’s total confirmed infections to over 24 million and raised the known overall death toll to more than 266,000 — numbers that experts say are vast undercounts.

The amendment, abruptly passed by the government in September, limits international charities that donate to local nonprofits. Almost overnight, it gutted a reliable source of funding for tens of thousands of nongovernmental organizations, or NGOs, which help provide basic health services in India, picking up the slack in a country where government spending in that area totals just 1.2 percent of gross domestic product.

The amendment also prompted international charities to cut back giving that supported local efforts in fields such as health, education and gender.

Newly formed charities are rushing to find NGOs that can accept their donations without tripping legal wires. And nonprofits are being smothered in red tape: To receive foreign funds, charities must get affidavits and notary stamps and open accounts with the government-owned State Bank of India.

“Everyone was caught off-guard,” said Nishant Pandey, chief executive of the American India Foundation, which has raised $23 million for Covid-19 efforts. On May 5, his group wired $3 million to an Indian affiliate to build 2,500 hospital beds. A week later, Mr. Pandey said, the money still hadn’t cleared.

Major U.S. retailers drop mask requirements for vaccinated shoppers, effectively moving to an honor system.

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A Walmart in Washington, D.C., last year. The retail giant is one of a number of major U.S. companies that is dropping mask mandates after new guidance from the Centers for Disease Control and Prevention.Credit...Andrew Caballero-Reynolds/Agence France-Presse — Getty Images

A growing number of major retailers are lifting mask requirements for those who are fully inoculated after new federal guidance, largely moving to an honor system in which they trust that only vaccinated people will bare their faces.

The guidance lifts the masking requirement for fully vaccinated people in most settings — though not on transit, in health care facilities or in certain crowded areas — while affirming that local regulations should still be respected. Fully vaccinated, according to the guidance, means two weeks after receiving a second dose of Pfizer-BioNTech’s or Moderna’s vaccine, or the single dose of Johnson & Johnson’s.

Walmart announced on Friday that fully vaccinated customers would no longer need to wear masks, and that fully vaccinated employees would no longer need to as of Tuesday. Costco and Publix are also lifting mask requirements for vaccinated people. Starbucks will also make masks optional for vaccinated customers starting on Monday, unless local regulations require them.

Many retailers said they would not require proof of vaccination. Costco, for instance, said it would instead “ask for members’ responsible and respectful cooperation with this revised policy.”

Trader Joe’s will no longer make vaccinated customers wear masks, although face coverings are still required for employees, Kenya Friend-Daniel, a spokesperson, said in a statement.

The Nevada Gaming Control Board also issued updated mask guidance on Thursday that follows the new federal guidelines, noting that it would not require casinos to confirm the vaccination status of patrons but would also not prevent them from doing so.

Some retailers like Target and CVS, though, plan to continue mandating face coverings for shoppers for now.

“CVS Health is currently re-evaluating its position on masks given the C.D.C.’s new guidance,” Joe Goode, a spokesman, said in a statement. “Until that evaluation is complete, the existing company policies on face coverings and maintaining social distance in stores and clinics remain in effect.”

The new guidance, released on Thursday by the Centers for Disease Control and Prevention, came as a surprise to many Americans. For months, federal officials warned that wearing masks and social distancing were necessary to control the spread of the virus. The guidance raised some disquiet, because there is no obvious way for retailers, their employees or their patrons to determine who has been vaccinated and who has not.

Some public health experts expressed concerns that unvaccinated people may also choose to shed their masks.

“CDC is betting that by giving wide freedom to vaccinated people it’ll encourage the hesitant,” Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law, wrote on Twitter on Thursday. “But there’s no behavioral evidence for that. What’s more likely to happen is that both vaccinated AND unvaccinated people will take off their masks.”

Union leaders have also pointed to the health risks that workers could face.

“Today’s C.D.C. guidance is confusing and fails to consider how it will impact essential workers who face frequent exposure to individuals who are not vaccinated and refuse to wear masks,” Marc Perrone, president of the United Food and Commercial Workers International Union, said in a statement on Thursday.

“Essential workers are still forced to play mask police for shoppers who are unvaccinated and refuse to follow local Covid safety measures,” he added.

There are alternatives to an honor system, in the form of documentation of vaccination. However, vaccine cards can be forged, and “vaccine passports” have become a contentious topic, with many Republican governors pushing back on them. Although the passports could help businesses operate more safely, critics argue that they raise privacy and equity concerns. Still, hundreds of airlines, governments and other organizations are experimenting with new, electronic versions.

On the question of a possible federal vaccine passport, Jen Psaki, the White House press secretary, said at a news briefing on Friday that the Biden administration remained focused on the vaccination campaign and was “not currently considering federal mandates.” But she left open the possibility that private-sector companies might want to require some kind of vaccine documentation, citing those “running a stadium, if you are a sports team or something like that.”

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