CoronavirusCovid News: Cambodia’s Reopening Is Propelled by Vaccinations

Cambodia’s reopening is propelled by vaccinations.

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Angkor Wat temple in Siem Reap province, Cambodia, in 2020, may be seeing greater numbers of tourists as Cambodia is set to welcome vaccinated international tourists without quarantine.Credit...Tang Chhin Sothy/Agence France-Presse — Getty Images

Cambodia reopened for fully vaccinated tourists from overseas this week without quarantine after a nationwide campaign succeeded in achieving one of the world’s highest vaccination rates.

The move was welcomed by desperate tourism operators and workers, who have struggled to make a living since the start of the pandemic.

“I rejoice at and fully support the news of reopening the country to vaccinated tourists without quarantine,” said Chhay Sivlin, the president of the Cambodia Association of Travel Agents. Tourism directly accounted for more than 12 percent of the country’s economy in 2019 and provided jobs to 630,000 people, she said.

Last month, the Southeast Asian nation of about 16 million announced plans to let fully vaccinated foreign tourists begin entering the country at the end of November if they first quarantined in selected areas for five days.

New reported cases by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
500 cases
7-day average
0
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

But citing the rapid pace of inoculations and a vaccination rate of 88 percent, Prime Minister Hun Sen accelerated that plan and said that fully vaccinated tourists could arrive without quarantine, effective on Monday.

“This is a big step towards reopening the entire country,” said Mr. Hun Sen, an authoritarian leader who came to power in 1984. “I hope our compatriots enjoy our reopening. It is widely due to the country having achieved such an outstanding rate of vaccination.”

While the prime minister put the fully vaccinated rate at 88 percent based on a population of 16 million, The New York Times database puts the rate at 80 percent, based on a population of nearly 16.5 million.

More than two million people have received a third dose.

About 90 percent of Cambodia’s vaccines came from China, including more than nine million doses of Sinovac and nearly four million doses of Sinopharm.

Under the new rules, travelers arriving from abroad can skip quarantine if they are fully vaccinated, test negative for the virus before departure and test negative again on arrival. Travelers who are not vaccinated must still spend 14 days in quarantine.

Ms. Sivlin said that tourist bookings were beginning to pick up and that airlines were working to increase the number of flights to Cambodia.

Some flights are scheduled to the capital, Phnom Penh, but none for Siem Reap, the town near the ancient city of Angkor that is one of the most popular destinations in Southeast Asia.

Like many of its neighbors, Cambodia reported relatively few virus cases in 2020 but faced a deadly surge this year. Still, its overall numbers have remained relatively low, with about 120,000 total cases and 2,900 deaths.

The U.S. Army secretary to National Guard members who resist the vaccines: Prepare for discipline.

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Members of the Oklahoma National Guard on the steps of the Senate on Capitol Hill in January.Credit...Erin Schaff/The New York Times

The secretary of the Army has issued a memo warning the hundreds of thousands of soldiers in its National Guard that if they decline to get vaccinated against the coronavirus, they may not be renewed in the guard.

“I have determined that all soldiers who refuse the mandatory vaccination order will be flagged,” wrote Christine E. Wormuth, the secretary, in a memo this week, which would prevent them from promotions, awards, bonuses and the like. If troops persist in declining, they will not be permitted “continued service” unless granted an approved exemption from the vaccine, she wrote.

Last week, Oklahoma’s newly appointed adjutant general for the National Guard, Brig. Gen. Thomas H. Mancino, announced on behalf of Gov. Kevin Stitt that guardsmen in the state would not be required to get a Covid-19 vaccine. The policy defies a Pentagon directive issued in August that makes vaccination mandatory for all troops, including the National Guard, by deadlines set by each service branch.

The memo created a testy stand off between Oklahoma officials and the Pentagon, which insists that all National Guard members must follow the same vaccine procedures as active duty troops. Guard troops are under the authority of the governor unless federally deployed. However, the Pentagon has stood its ground on the notion that its vaccine mandate trumps states’ rights.

In Oklahoma, 89 percent of airmen in the Guard have been vaccinated, while only 40 percent of Army guardsmen have had shots; the deadline for members of the Army National Guard is coming next month. All branches of the military have been permitted to come up with their own vaccine mandate deadlines for active duty and guard troops, as well as their own punishment systems for refusing shots.

The Pentagon has been wary that other states may follow Oklahoma’s lead.

Texas Guard officials, for instance, said in an email that the Pentagon appeared to be imposing vaccine mandates on military and National Guard members without adequate protections in place for individuals with religious objections and hinted it, too, might permit members to skip the shots.

The governor of Alaska, Mike Dunleavy, has also issued a memo noting that “President Biden and his Administration have taken actions, or announced plans to act, that threaten the sovereign authority of the State of Alaska,” which included “imposing vaccine mandates on military and National Guard members without adequate protections in place for individuals with religious objections.”

In essence, Texas and Alaska appear to be engaged in a passive version of the Oklahoma written policy. “We are awaiting additional guidance from the Departments of the U.S. Army and Air Force that addresses National Guard requirements,” said Candis Olmstead, a spokeswoman for the Alaska Guard, in an email.

So far, the Defense Department has granted a smattering of exemptions from vaccines, including for people who were already leaving the military or who have medical issues, but those for religious reasons are still pending.

Tracking the Coronavirus ›

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Greece, like some other E.U. nations facing case surges, adds restrictions for the unvaccinated.

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Medical workers protesting mandatory vaccinations and the indefinite suspension of healthcare employees who have not been vaccinated, in Athens, in early November.Credit...Alkis Konstantinidis/Reuters

Prime Minister Kyriakos Mitsotakis of Greece announced additional restrictions for the country’s unvaccinated population on Thursday, a bid to keep a recent spike of coronavirus infections from increasing further.

As of next Monday, access to more indoor spaces will be limited to the vaccinated, he said during a televised address. Proof of a negative test will no longer be sufficient for unvaccinated people to enter cinemas, theaters, museums and gymnasiums, he said. The new restrictions broaden those imposed in mid-September, which barred the unvaccinated from the indoor areas of cafes and restaurants.

New reported cases by day
Mar. 2020
Oct.
May 2021
Dec.
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Feb. 2023
20,000
40,000 cases
7-day average
0
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

To increase demand for booster shots, Mr. Mitsotakis also said that the vaccination certificates of those over 60 would expire after seven months. Greece opened eligibility for booster shots last week for all those over 18 who had their last shot at least five and a half months ago. Those who got the Pfizer, AstraZeneca or Moderna vaccines initially were advised to get a Pfizer or Moderna booster. Those who received the Johnson & Johnson shot were advised to get Pfizer, Moderna or a second Johnson & Johnson shot as a booster.

Mr. Mitsotakis appealed to all, particularly the unvaccinated elderly, to get their shots without delay.

“Greece is mourning unnecessary losses as it very simply does not have the vaccination rates of other European countries,” he said.

About 61 percent of Greeks are fully vaccinated, below the average rate in the European Union of 65.4 percent, according to the vaccine tracker of the European Centre for Disease Prevention and Control. Since the end of September, new daily cases have shot up from an average of about 2,100 to more than 6,500, according to the Our World in Data project at Oxford University, and daily Covid deaths have spiked over the same period, going from an average of around 30 to more than 74.

Global coronavirus cases by region

This chart shows how reported cases per capita have changed in different parts of the world.

  • Africa
  • Asia-Pacific
  • Europe
  • Latin America
  • Middle East
  • U.S. and Canada
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
100 cases
200 cases per 100,000
Sources: Center for Systems Science and Engineering at Johns Hopkins University and state and local health agencies (cases); World Bank and U.S. Census Bureau (population data).

With Europe as a whole experiencing a sustained wave of cases, the sharp restrictions in Greece have been matched or surpassed by other E.U. nations. Austria, for instance, will impose full lockdowns in two states — Salzburg and Upper Austria — next week, after having imposed broad restrictions on the activities of unvaccinated people.

On Thursday, lawmakers in Germany’s Parliament approved a bill whose measures include a rule that only people who are vaccinated against the virus, have recovered from an infection or test negative can ride public transit or attend work in person. The measure is expected to be passed by all 16 states on Friday.

France and Italy have allowed people to enter indoor areas such as cafes, museums and gyms with a health pass that shows the holder has been vaccinated, has recovered from Covid-19 or has tested negative for the virus. However, both countries are reportedly considering restricting access to such areas to the vaccinated.

The Czech Republic, which is experiencing some of its highest caseloads since the pandemic began, will bar people without a vaccination pass or proof of a previous Covid infection from restaurants, bars and hair salons as of Monday. They will also be barred from attending large events.

New reported cases by day
Mar. 2020
Oct.
May 2021
Dec.
Jul. 2022
Feb. 2023
20,000
40,000 cases
7-day average
896
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

And lawmakers in the Netherlands, which is reporting record case numbers and sharply rising positive tests, recently restored mask mandates in some public indoor places and instituted a three-week partial lockdown that includes earlier closing hours for restaurants, bars and shops. However, the Dutch government has resisted urgings to close schools, despite significant outbreaks among those aged 4 through 12.

Utah and Massachusetts expand access to boosters for all adults, joining several other states.

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At a mass coronavirus vaccination site in Natick, Mass., in February.Credit...Pool photo by Matt Stone

Utah and Massachusetts on Thursday joined a growing number of states in broadening access to coronavirus vaccine boosters for all adults, just as federal regulators consider granting requests for Pfizer-BioNTech and Moderna boosters to be authorized for all adults as early as this week, according to people familiar with the planning.

The administration of Gov. Charlie Baker announced that all Massachusetts residents ages 18 and older could get a booster, if they met the federal timing rules: six months after receiving the second dose of the Pfizer or Moderna vaccines or two months past getting the single-dose Johnson & Johnson vaccine.

At a news conference on Thursday, Gov. Spencer J. Cox of Utah asked all health care providers to provide boosters to “any adult in the state of Utah who would like to receive a booster” beginning on Friday, in accordance with the same federal guidelines that Massachusetts was using.

While federal regulators have signed off on boosters for only certain categories of people, some states have used a range of justifications to expand access, including heightened risks posed by holiday gatherings and the pervasive spread of the virus.

In Connecticut, Gov. Ned Lamont encouraged vaccinated adults to get a booster provided they meet timing rules, even if they might not appear to fit into federal eligibility categories.

“C.D.C. speaks Latin, I can’t figure out who’s eligible, who’s not eligible,” said Mr. Lamont at a news conference on Thursday, referring to the Centers for Disease Control and Prevention. “If you smoked while you were in high school back in the 1970s, you’re eligible. I think if you haven’t been vaccinated in more than six months, now’s the time to get the booster. Self report, you’re at risk or public facing, you’re out there, get the booster.”

The moves came as Kansas, Kentucky, Maine and Vermont also moved to expand access to boosters, following several other states and New York City.

The director of Rhode Island’s department of health, Dr. Nicole Alexander-Scott, announced on Tuesday that all adults could get a booster if they were past the federal timing rules. “Winter’s coming, our cases have gone up and everyone 18 and older is at higher risk of exposure. And so we want the message to go out that you can go ahead and get your booster shots,” she said at a news conference.

On Thursday, Jen Psaki, the White House press secretary, said the administration would “wait for the process to proceed” at the federal level. She also encouraged people already eligible according to federal categories to get a booster for extra protection ahead of the holiday season when people may be traveling more and gathering inside because of colder weather.

Currently, federal regulators say people who received two doses of the Pfizer-BioNTech or Moderna vaccines, meet timing rules, and are 65 or older, or adults who are considered to be at special risk because of their medical conditions, jobs or living environments are eligible for boosters. Anyone who received the Johnson & Johnson shot can already get a booster two months after the first shot. Eligible people can select from any of three vaccine brands as a booster.

A growing body of global research has shown that the vaccines available in the United States have remained highly protective against the disease’s worst outcomes over time, even during the summer surge of the highly transmissible Delta variant. And there has been an ongoing debate among experts over whether extra shots are necessary for younger, healthy adults.

Liam Stack and Todd Gregory contributed reporting.

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The first known Covid case was a vendor at a Wuhan market, a scientist claims.

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A Wuhan hygiene emergency response vehicle leaving the closed Huanan seafood market in January 2020.Credit...Noel Celis/Agence France-Presse — Getty Images

A scientist who has pored over public accounts of early Covid-19 cases in China reported on Thursday that an influential World Health Organization inquiry had likely gotten the early chronology of the pandemic wrong. The new analysis suggests that the first known patient sickened with the coronavirus was a vendor in a large Wuhan animal market, not an accountant who lived many miles from it.

The report, published on Thursday in the prestigious journal Science, will revive, though certainly not settle, the debate over whether the pandemic started with a spillover from wildlife sold at the market, a leak from a Wuhan virology lab or some other way. The search for the origins of the greatest public health catastrophe in a century has fueled geopolitical battles, with few new facts emerging in recent months to resolve the question.

The scientist, Michael Worobey, a leading expert in tracing the evolution of viruses at the University of Arizona, came upon timeline discrepancies by combing through what had already been made public in medical journals, as well as video interviews in a Chinese news outlet with people believed to have the first two documented infections.

Dr. Worobey argues that the vendor’s ties to the Huanan Seafood Wholesale Market, as well as a new analysis of the earliest hospitalized patients’ connections to the market, strongly suggest that the pandemic began there.

“In this city of 11 million people, half of the early cases are linked to a place that’s the size of a soccer field,” Dr. Worobey said. “It becomes very difficult to explain that pattern if the outbreak didn’t start at the market.”

Several experts, including one of the pandemic investigators chosen by the W.H.O., said that Dr. Worobey’s detective work was sound and that the first known case of Covid was most likely a seafood vendor.

But some of them also said the evidence was still insufficient to decisively settle the larger question of how the pandemic began. They suggested that the virus probably infected a “patient zero” sometime before the vendor’s case and then reached critical mass to spread widely at the market. Studies of changes in the virus’s genome — including one done by Dr. Worobey himself — have suggested that the first infection happened in roughly mid-November 2019, weeks before the vendor got sick.

Canada and Mexico are expected to announce a regional Covid vaccine-sharing plan at a White House summit.

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President Biden, with Prime Minister Justin Trudeau of Canada, right, and President Andrés Manuel López Obrador of Mexico, at a summit in the White House on Thursday.Credit...Doug Mills/The New York Times

The leaders of Canada and Mexico will announce a pledge to send millions of coronavirus vaccines to much of Latin America and the Caribbean on Thursday during a summit with President Biden, according to a White House official with knowledge of the agenda.

Prime Minister Justin Trudeau of Canada and President Andrés Manuel López Obrador of Mexico are expected to unveil the plan during a meeting with Mr. Biden on Thursday, the first meeting of all three leaders of North America in five years.

In addition to the announcement regarding vaccines, leaders are expected to review and update a regional plan from 2012 for addressing animal and pandemic influenza, and to address delicate issues around trade and migration.

[Read our latest coverage of the summit meeting.]

The donations come as part of a regional strategy through which the United States first shared millions of Covid vaccine doses with Mexico and Canada, and those countries now are moving ahead to distribute doses to the rest of the region.

In March, shortly after coronavirus vaccines became widely available, the United States announced that it would share 2.5 million doses with Mexico and 1.5 million with Canada as part of a larger diplomatic effort to rebuild ties with its neighbors.

The United States has since donated nearly 11 million doses to Mexico, or nearly 10 percent of that country’s total vaccine stock, according to the official.

Canada’s distribution of Covid vaccines was hampered by delays and bottlenecks in the spring, but vaccination rates there have since climbed dramatically. The country quickly surpassed the United States and now has fully vaccinated 77 percent of its population, as compared to the U.S. total of 59 percent, according to vaccination data compiled by The New York Times.

But the leaders appeared eager to project a sense of cooperativeness in confronting public health in the region, marking a significant change from their countries’ idled diplomatic efforts under the Trump administration.

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With restrictions easing, the Australian Open can play before a full house.

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Novak Djokovic after winning the Australian Open men’s singles title in Melbourne in February. Credit...Andy Brownbill/Associated Press

Two of Australia’s biggest sports events — the Australian Open tennis tournament and the annual Boxing Day cricket test match in Melbourne — will be allowed to take place before full-capacity stadiums as part of an easing of coronavirus restrictions.

With 90 percent of people over 16 expected to be fully vaccinated by this weekend in the state of Victoria, of which Melbourne is the capital, the authorities are easing pandemic-related rules, including capacity limits for public events.

Events with up to 30,000 spectators can be held without state government approval, and larger events can go ahead at full capacity if they have a government-approved coronavirus safety plan in place.

Attendees at all sports events will be required to be fully vaccinated.

The Australian Open, which is played early each year in Melbourne, attracted about 820,000 spectators over two weeks the last time it was held at full capacity, in 2020. The Grand Slam tournament is played in a variety of venues, with the largest, Rod Laver Arena, able to seat about 15,000 spectators.

Last year, attendance was capped at 30,000 fans a day for the first five days before spectators were barred as Melbourne dealt with another outbreak. The tournament’s final four days were played at 50 percent capacity.

It is unclear whether unvaccinated tennis players or players who do not reveal their vaccination status — including the world No. 1, Novak Djokovic — will be able to attend the Australian Open. The Victoria government said in late October that it would not seek exemptions for unvaccinated players to enter the country. International visitors require a government exemption in order to enter Australia.

Spectators will also be able to fill the Melbourne Cricket Ground, which has a capacity of 100,000, to watch the Boxing Day cricket test match between Australia and England on Dec. 26. The test match is part of the Ashes, a series between England and Australia that is held every two years and is one of the biggest events in cricket.

“Whether it’s 100,000 people at the M.C.G. on Boxing Day or a smaller group of people standing up at the public bar of their pub having a beer, this is the Covid-normal that every Victorian has built,” the premier of Victoria, Daniel Andrews, said at a news conference on Thursday.

Other restrictions in Victoria are also being lifted. Starting on Friday, restrictions end on the number of people allowed in restaurants and bars, and masks will no longer be mandatory in most settings.

As India limits syringe exports, a supply crunch has buyers looking elsewhere.

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Workers checking syringes at Hindustan Syringes and Medical Devices, one of the world’s largest syringe makers.Credit...Rebecca Conway for The New York Times

NEW DELHI — Rajiv Nath’s factories were cranking out more than 7,600 syringes a minute when India decided to limit their export last month to shore up its own vaccination campaign.

The products were meant for clients around the world as nations scramble to inoculate their people and bring the pandemic to an end, but instead Mr. Nath’s warehouses were left with stocks of more than 45 million syringes that he had largely promised to UNICEF and the Pan American Health Organization.

And with India’s export restrictions on syringes in place through the end of this year, experts say the world could experience a shortfall of two billion to four billion needles through the end of next year. The shortages are expected to hit African countries the hardest.

“That will be truly disappointing,” said Prashant Yadav — a senior fellow at the Center for Global Development, a Washington research organization, and an expert on health care supply chains — “that after having waited for over a year to get a reasonable quantity of vaccines, when they do obtain the vaccines, they don’t have syringes to administer them.”

Although India is a small player in overall global exports, it is a major producer of the type of syringe that is being used globally for coronavirus vaccinations. The syringes break on second use to prevent the spreading of disease through reuse.

Covax, the vaccine-sharing initiative, is seeking the syringes from manufacturers around the world, and India was expected to meet at least 15 percent of the global demand for use with Covid vaccines and other inoculations.

The situation became so acute last month that the World Health Organization and PAHO asked India to allow Mr. Nath’s company, Hindustan Syringes and Medical Devices, one of the world’s largest syringe makers, to ship the orders it had agreed to before the restrictions were announced. Prime Minister Narendra Modi’s government subsequently increased the export quota for the health organizations but did not allow a blanket exemption.

The World Health Organization and UNICEF have warned that the syringe shortage could have “dire consequences” for the global vaccination effort.

In India, more than half of the 1.4 billion-strong population has received at least one shot of a Covid vaccine, but only 28 percent of people are fully vaccinated, according to a New York Times database. And new inoculations have slowed recently.

Unlike vaccine doses, syringes are bulky and are typically transported by sea. The shortage comes amid large disruptions in the global supply chain of shipped goods, and experts say that a Covax-like initiative is needed, with nations coming together to better supply syringes to poorer countries.

UNICEF, a major buyer of syringes for Covax, said in a statement on Wednesday that “syringe nationalism” could be addressed if big producers and wealthy countries “influence global markets in a way that unlocks access for other countries in the global south.”

The agency also said it was considering expanding use of another type of syringe approved by the W.H.O. that also prevents reuse.

Dozens of Indian syringe makers spent millions of dollars to scale up manufacturing last year, but buyers are increasingly relying on manufacturers in China.

ProcureNet, a Hong Kong-based supplier of pharmaceutical products, said this week that it would invest $20 million in Anhui Tiankang Medical, a Chinese manufacturer, to produce 750 million syringes for PAHO and other buyers.

“We continue to spend billions on the vaccine,” said Gurbaksh Chahal, ProcureNet’s chief executive, “but what good is the vaccine if we don’t have the tools to deliver the vaccine to the people?”

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Florida curtails virus mandates, reflecting the wishes of vaccine skeptics.

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Dr. Carmen Martinez, an internal medicine specialist from Jacksonville, Fla., outside the Capitol during a special legislative session considering bills targeting Covid vaccine mandates.Credit...Rebecca Blackwell/Associated Press

Almost entirely along party lines, Republican Florida lawmakers passed four bills on Wednesday to curtail mask and vaccine mandates, the culmination of a three-day special legislative session that Gov. Ron DeSantis called so swiftly that it caught even Republican leaders by surprise.

Mr. DeSantis said the session was urgently needed to combat federal government overreach. In addition to Florida, at least five other states have considered or held special sessions on pandemic mandates, according to the National Conference of State Legislatures.

Early this year, Mr. DeSantis crisscrossed Florida to promote Covid vaccines, visiting retiree communities and hospitals, and celebrating people who had gotten their shots. But it was a remarkably different picture this week, when Florida’s lieutenant governor, Jeanette Nuñez, was a prominent speaker at a rally organized by anti-vaccination campaigners on the State Capitol steps.

Covid patients in hospitals and I.C.U.s
Early data may be incomplete.
Mar. 2020
Oct.
May 2021
Dec.
Jul. 2022
Feb. 2023
5,000
10,000
15,000 hospitalized
Hospitalized
In I.C.U.s
0
Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.

That scene moved the state further away from the guidance of federal public health officials, reflecting how a highly politicized pandemic has become more so as Republican-controlled states confront the Biden administration’s wide-ranging attempts to ease it.

Perhaps no state has been more aggressive than Florida, where Mr. DeSantis and his allies are betting that the anger over public health restrictions that drove Republicans to the polls this month in Virginia, New Jersey and other states will grow their political base and keep voters fervently engaged going into the 2022 midterms.

A vaccine developed by Novavax, a Maryland-based company, is approved in the Philippines.

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An inoculation drive in Quezon City, the Philippines, on Wednesday. The country has now approved nine vaccines for emergency use.Credit...Aaron Favila/Associated Press

The Philippines has granted emergency-use authorization for Novavax’s Covid-19 vaccine for people 18 and older, giving a boost to the Maryland-based company and becoming the second country after Indonesia to allow the shots.

Novavax has also submitted applications for emergency use in India and with the World Health Organization. And the European Union’s main drug regulator said on Wednesday that it could decide whether to issue conditional marketing authorization “within weeks” if the drugmaker’s data show the vaccine to be safe and effective.

The Novavax shots proved highly effective in clinical trials, but the company fell behind other manufacturers despite receiving $1.75 billion from the U.S. government. Novavax struggled to ramp up its manufacturing and to demonstrate the purity of its vaccines to regulators, and it said in August that Washington would not pay for further production until it had resolved regulators’ concerns.

New reported cases by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
10,000
20,000
30,000 cases
7-day average
126
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

The vaccine involves two doses, given at least 21 days apart, the company said. It differs from the shots now authorized in the United States in that it involves viral proteins assembled into nanoparticles, mixed with an immune-boosting compound called an adjuvant.

Indonesia approved Novavax’s vaccine for emergency use this month.

Novavax’s chief executive, Stanley C. Erck, said in an announcement on Wednesday that the shots would “contribute substantially to increased vaccination rates” in the Philippines, where only about 37 percent of the population is fully vaccinated, according to the Our World in Data project at the University of Oxford.

The vaccine doses will be manufactured by the Serum Institute in India.

The E.U. drug regulator, the European Medicines Agency, has approved the use of the AstraZeneca, Janssen, Moderna and Pfizer-BioNTech vaccines. The approval of a fifth vaccine could bolster inoculation drives on the continent at a time when it is experiencing the world’s biggest Covid outbreaks.

The Philippines had already approved eight other vaccines for emergency use, according to Dr. Rolando Enrique Domingo, director of the Philippine Food and Drug Administration: AstraZeneca, Bharat Biotech, Gamaleya Sputnik V, Johnson & Johnson, Moderna, Pfizer-BioNTech, Sinopharm, and Sinovac.

Vince Dizon, an adviser to President Rodrigo Duterte, has said that because of unequal vaccine distribution, the Philippines needed to approve as many vaccines as it could.

“There is a really big problem with the global supply of vaccines, because many of these vaccines are in rich countries,” he said. “We need to be vaccinated quickly.”

A correction was made on 
Nov. 18, 2021

An earlier version of this item misidentified the person who said that because of unequal vaccine distribution throughout the world, the Philippines needed to approve as many vaccines as it could. It was Vince Dizon, an adviser to the Philippine president, not Rolando Enrique Domingo, the director of the Philippine Food and Drug Administration. 

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Officials expect U.S. travel for Thanksgiving to approach prepandemic levels.

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The T.S.A. security checkpoint at Louis Armstrong New Orleans International Airport during a busy period in August ahead of Hurricane Ida.Credit...Scott Olson/Getty Images

Airline travel this Thanksgiving season is expected to approach prepandemic levels, Transportation Security Administration officials said on Wednesday. The agency is preparing to handle about 20 million air passengers.

“We are staffed and prepared for the holiday travelers,” David Pekoske, the T.S.A. administrator, said in a statement.

The large volume of travelers expected comes as inoculation rates across the United States have risen, allowing many families to gather safely for the first time since 2019, when T.S.A. screened 26 million people. The uptick also signals a willingness by people to resume customary holiday travel.

“I recommend that travelers pay attention to the guidance that the T.S.A. officers are providing at the checkpoint,” Mr. Pekoske said. “They may be directing you to a shorter line or guiding you around someone who is moving slowly, and they may be giving you some advice that will lessen the likelihood that you’ll need a pat-down.”

Coronavirus cases in the United States by region

This chart shows how reported cases per capita have changed in different parts of the country. The state with the highest recent cases per capita is shown.

The busiest days during the Thanksgiving travel period are usually the Tuesday and Wednesday before Thanksgiving and the Sunday afterward, the T.S.A. statement said. While the travel volume this year is not expected to reach 2019 levels, the agency said it could be higher in the time leading up to Thanksgiving.

The increase comes as airlines deal with an uptick in cases of unruly passengers. The Federal Aviation Administration has issued fines, and the president of the Association of Flight Attendants union, Sara Nelson, has attributed the rising tensions to the politically charged atmosphere over health protocols.

In an interview with “CBS Mornings,” Mr. Pekoske said the number of such reports were higher than he can recall ever having seen.

“We’re working very closely with the carriers, the flight attendants, the flight deck crews, the air force and the F.A.A., to do everything that we can to message how dangerous this behavior is,” he said.

Does that virus test swab really have to go that far into your nose?

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Getting a Covid nasal test in Seoul.Credit...Chang W. Lee/The New York Times

One Canadian said it felt like a painful poke to his brain. An American heard crunching sounds in her head. A Frenchwoman suffered a severe nosebleed. Others got headaches, cried or were left in shock.

They were all tested for the coronavirus with deep nasal swabs. While many people have no complaints about their experience, for some, the swab test — a vital tool in global efforts to quash the coronavirus — engenders visceral dislike, severe squirming or buckled knees.

“It felt like someone was going right into the reset button of my brain to switch something over,” Paul Chin, a music producer and DJ in Toronto, said of his nasal swab test. “There’s truly nothing like it.”

Nasal cavity

Swab

Throat

Nasal cavity

Swab

Throat

Nasal cavity

Swab

Throat

Illustration by Guilbert Gates

Since the coronavirus emerged, millions of swabs have been stuck into millions of noses to test for a pernicious virus that has killed millions across the planet. One of the ways to fight the virus, officials say, is to test widely and to test often.

The imperative has been to use a test that people are willing to take repeatedly, and the swab generally fits the bill.

Yet the range of swabbing raises questions: Who is doing it right? How deeply should the swab slide into the nostril? How long should it spend up there? Does an accurate test have to be uncomfortable?

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CVS will close 900 stores as it looks beyond traditional pharmacies.

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CVS operates more than 9,900 retail stores in the United States.Credit...Nicole Craine for The New York Times

CVS will close about 300 stores a year in the next three years, the company said on Thursday, as the pharmacy chain focuses on offering more health care services and expanding its digital services.

The closures, which will affect about 9 percent of the company’s stores, are part of an effort to realign its retail strategy, CVS said in statement on its website.

The company operates more than 9,900 stores in the United States, according to its website. A CVS spokesman said the company did not expect CVS pharmacies in Target stores to be affected.

“We remain focused on the competitive advantage provided by our presence in thousands of communities across the country, which complements our rapidly expanding digital presence,” said Karen S. Lynch, the president and chief executive of CVS Health.

CVS is aiming to remake many of its stores. Some will offer primary care services, and others will offer broader health care services than standard pharmacies, such as treatment for diabetes. The company will also maintain traditional CVS stores, which provide prescription services and health products.

“Hybrid models really took off during the pandemic, including rapid delivery services, curbside pickup and buy online/pick up in-store,” said Ted Rossman, a senior analyst at Bankrate.com. “Those approaches could be particularly advantageous for CVS.”

CVS said earlier this month that about 70 percent of CVS Pharmacy customers were enrolled in its text messaging program.

“We continue to modernize our operating systems and enhance the integration of pharmacy models, simplifying consumer interactions and driving further engagement with our customers,” Ms. Lynch said during the company’s earnings conference call on Nov. 3.

The C.D.C. endorses Pfizer-BioNTech and Moderna boosters for all adults.

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Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, on Friday accepted the recommendation of a C.D.C. panel that all adults get booster shots.Credit...Stefani Reynolds for The New York Times

The Centers for Disease Control and Prevention on Friday endorsed booster shots of the Pfizer-BioNTech and Moderna coronavirus vaccines for all adults, a move that brings tens of millions fully vaccinated people a step closer to a third shot.

Boosters are recommended six months after the second shot of the Pfizer-BioNTech or Moderna vaccines. With this final step, boosters should be available this weekend, allowing many Americans to get a shot before the Thanksgiving holiday.

The new recommendations say that everyone 50 and older — most of whom have other risk factors — as well as those 18 and older living in long-term care facilities “should” get a booster. Other Americans who are 18 and older “may” opt for one if they wish, based on individual risk and benefit.

Several advisers said at the meeting that they hoped the simpler age-based guidelines would ease some of the confusion around who is eligible for the extra shots.

An advisory committee to the C.D.C. unanimously voted in favor of the booster shots. Dr. Rochelle Walensky, the agency’s director, later formally accepted the recommendation. The recommendations align with President Biden’s promise in August that all adults would be eligible for extra doses.

Desperate to dampen even a dim echo of last winter’s horrors, the administration is betting that booster shots will shore up what some have characterized as waning immunity among the fully vaccinated.

The Food and Drug Administration authorized boosters of the Pfizer-BioNTech and Moderna vaccines for all adults on Friday, but the C.D.C. generally makes the recommendations followed by the medical profession.

In recent days, several states have broadened booster access to all adults on their own.

Addressing the panelists, Dr. Sam Posner, the acting director of the National Center for Immunization and Respiratory Diseases, acknowledged that previous eligibility categories “were complicated to implement” and said he hoped that simplifying them “will reduce confusion.”

After a brief respite, coronavirus infections are inching up again, particularly in parts of the country where cooler weather is hustling people indoors. Research suggests that the shots may help forestall at least some infections, particularly in older adults and those with certain health conditions.

The C.D.C.’s decision lands just as Americans are preparing to spend the holidays with family and friends. Given the tens of millions of Americans who have yet to receive a single dose of vaccine, holiday travel and get-togethers could send cases skyrocketing, as they did last year.

Several European countries are also offering boosters to all adults in a bid to contain fresh waves of infections. France has gone so far as to mandate booster shots for people over age 65 who wish to get a health pass permitting access to public venues.

Noah Weiland and Dan Levin contributed reporting.

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A man in China is sentenced for hiding an infection while crossing the border.

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Many shoppers at an outdoor mall in Beijing this month were wearing masks.Credit...Mark Schiefelbein/Associated Press

A court in a southern Chinese border region said this week that it had given a man a two-year suspended prison sentence for lying when he entered the country about whether he had been exposed to the coronavirus or developed symptoms.

The move is the latest sign of China’s efforts to chase full elimination of the virus through stringent “Covid zero” measures, even as the rest of the world looks to open up.

The man, who was identified only by his surname, Cao, was convicted of lying on a health declaration form when he crossed China’s border with Vietnam in late April, the court said on its Weixin social media account.

He concealed that he had been staying in a hotel in Vietnam where some people with coronavirus infections were also staying, the court said. Then he obtained cold medicine and hid a fever and other symptoms consistent with a coronavirus infection.

Once in China, he also sneaked out of his quarantine room to meet friends, the court said. Mr. Cao could not be reached for comment.

New reported cases by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
20,000
40,000
60,000 cases
7-day average
0

These are days with a reporting anomaly.

Source: Data for China comes from the Center for Systems Science and Engineering at Johns Hopkins University. Population data from the National Bureau of Statistics of China. Data does not include Hong Kong, Macau or Taiwan. The daily average is calculated with data that was reported in the last seven days.

The court in Pingxiang, along the Vietnam border in China’s Guangxi region, posted the announcement to its Weixin account on Wednesday. It said it had fined Mr. Cao $31,000.

The court statement and a report by the official Xinhua news agency said that Mr. Cao had symptoms consistent with the coronavirus, but did not say whether he had tested positive for the disease. Huang Qinmei, the deputy mayor of Chongzuo, the city of which Pingxiang is part, said at a news conference in May that Mr. Cao had tested positive.

Because Mr. Cao concealed information about his Covid exposure and apparent symptoms, the court said, 459 people who came in direct or indirect contact with him were also quarantined at a cost to the government of about $100,000. Another 29 customs staff members had to stay in their homes for 14 days.

Some social media users posted comments on the Xinhua report contending that the punishment was not harsh enough.

Li You contributed research.

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